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Individual

HENRY B KOON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(216) 844-3951
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HTS, OH 44122
(216) 286-6295
(216) 286-6341

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
154133
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221364
UNISUN
OH
01
000000527718
ANTHEM
OH
05
2762587
OH
01
414994
WELLCARE
OH
01
750817
BUCKEYE
OH
01
7538343
AETNA
OH
Enumeration date
07/07/2006
Last updated
01/23/2009
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