Individual
SHAUN MICHAEL ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
6701 ROCKSIDE RD, SUITE 103, INDEPENDENCE, OH 44131-2358
(216) 369-2800
(216) 369-0456
Mailing address
7580 NORTHCLIFF AVE, SUITE 500, BROOKLYN, OH 44144-3270
(216) 472-2741
(216) 472-2739
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001422
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069895
—
OH
Enumeration date
08/09/2005
Last updated
10/12/2012
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