Individual
DR. SUZANNE DENISE DEBROSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11100 EUCLID AVE, LAKESIDE 1500, CLEVELAND, OH 44106-1716
(216) 844-3936
(216) 844-7497
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
35.094127
OH
208000000X
Pediatrics Physician
35-094127
OH
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
35.094127
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000725150
ANTHEM
—
05
—
0056505
—
OH
01
—
2048816199ER
CARESOURCE
OH
01
—
35.094127
LICENSE
OH
01
—
609409
WELLCARE
OH
01
—
9648753
AETNA
—
Enumeration date
05/11/2007
Last updated
12/09/2020
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