Individual
AMANDA K WEISS-KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-082723
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221116
UNISON
OH
01
—
000000289033
ANTHEM
OH
01
—
000000526168
ANTHEM
OH
01
—
2435092
BCMH
OH
05
—
2435092
—
OH
01
—
364124
WELLCARE
OH
01
—
745986
BUCKEYE
OH
01
—
781351
AETNA
OH
Enumeration date
07/15/2006
Last updated
01/13/2021
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