Individual
ANN M BACEVICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(216) 844-7700
(216) 286-6341
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
35080264
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221286
UNISON
OH
01
—
000000527950
ANTHEM
OH
01
—
1021123120001
PA MEDICAID
PA
05
—
2350263
—
OH
01
—
363418
WELLCARE
OH
01
—
750458
BUCKEYE
OH
01
—
7515338
AETNA
OH
01
—
P00411237
RAILROAD MEDICARE
OH
Enumeration date
07/06/2006
Last updated
06/30/2011
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