Individual
GREGORY BOURDAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(800) 223-2273
Mailing address
6000 W CREEK RD, SUITE 10, INDEPENDENCE, OH 44131-2139
(800) 223-2273
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
35064702
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35064702B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2181571
—
OH
Enumeration date
04/11/2006
Last updated
09/17/2014
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