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Individual

LISA M EVERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7330
Mailing address
1004 SOUTH ROCK STREET, EASTER MEDICAL STAFFING, GEORGETOWN, TX 78626
(512) 374-1876

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35-087953
OH
207LA0401X
Addiction Medicine (Anesthesiology) Physician
35-087953
OH
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
35-087953
OH
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
35-087953
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
35-087953
OH
207LP3000X
Pediatric Anesthesiology Physician
35-087953
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221395
UNISON
OH
01
000000541269
ANTHEM
OH
01
0583328
BCMH
OH
01
1811000284
MICHIGAN MEDICAID
MI
05
2681012
OH
01
363600
WELLCARE MEDICAID
OH
01
746258
BUCKEYE MEDICAID
OH
01
7839837
AETNA
OH
01
P00400485
MEDICARE RAILROAD
OH
Enumeration date
08/17/2006
Last updated
07/10/2012
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