Individual
ETHAN JOHN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 798-4658
Mailing address
6789 MAYFIELD HTS, MAYFIELD, OH 44124-1973
(440) 312-4500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
LE-00030982
OH
Other
Enumeration date
12/30/2019
Last updated
10/08/2021
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