Individual
JAY DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
13207 RAVENNA RD, GEAUGA HOSPITAL, CHARDON, OH 44024-7032
(440) 285-6000
Mailing address
PO BOX 567, CHAGRIN FALLS, OH 44022-0567
(216) 464-5160
(216) 464-5982
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
247880
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221227
UNISON
OH
01
—
000000515990
ANTHEM
OH
05
—
2380589
—
OH
01
—
414966
WELLCARE MEDICAID
OH
01
—
7008730
AETNA
OH
01
—
730548
BUCKEYE MEDICAID
OH
01
—
P00416766
MEDICARE RAILROAD
OH
Enumeration date
08/26/2005
Last updated
06/21/2011
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