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Individual

RICHARD ALLEN STATESIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14701 DETROIT AVE, STE 280, LAKEWOOD, OH 44107-4109
(216) 228-9122
(216) 221-9773
Mailing address
14701 DETROIT AVE STE 280, LAKEWOOD, OH 44107-4109
(216) 228-9122
(216) 221-9773

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35053677S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0626273
OH
Enumeration date
05/28/2005
Last updated
09/10/2025
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