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Individual

SRI KRISHNA MADAN MOHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3800
Mailing address
8055 MAYFIELD RD STE 105, CHESTERLAND, OH 44026-2447

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35073553
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35073553
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000225072
UNISON NUMBER
OH
01
000000305457
ANTHEM BLUE CROSS BLUE SH
OH
01
000000537787
ANTHEM NUMBER
OH
01
100656
KAISER
OH
01
1765539
UNITED HEALTHCARE
OH
05
2036960
OH
01
341487428
TAX ID
OH
01
414785
AETNA NUMBER
OH
01
496700001
CARESOURCE
OH
01
5283617
AETNA NUMBER
OH
01
740678
BUCKEYE NUMBER
OH
01
81335
QUALCHOICE
OH
01
P00045244
RAILROAD MEDICARE
OH
01
P00422676
MEDICARE RAILROAD
OH
01
P73553
SUMMACARE
OH
Enumeration date
07/02/2006
Last updated
04/18/2018
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