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Individual

KORD HONDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8200
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-1507

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35087741
OH
207ND0900X
Dermatopathology Physician
Primary
35087741
OH
207ZD0900X
Dermatopathology (Pathology) Physician
MD00040145
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221421
UNISON
OH
01
000000523746
ANTHEM
OH
01
1020792270001
PENNSYLVANIA MEDICAID
PA
05
2667485
OH
01
414683
WELLCARE
OH
01
744887
BUCKEYE
OH
01
7663844
AETNA
OH
01
P00406579
RAILROAD MEDICARE
OH
Enumeration date
06/02/2006
Last updated
12/18/2020
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