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Individual

DR. MALGORZATA A BAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5334 MEADOW LANE COURT, SHEFFIELD VILLAGE, OH 44035-1469
(440) 934-5454
(440) 934-8979
Mailing address
5334 MEADOW LANE COURT, SHEFFIELD VILLAGE, OH 44035-1469
(440) 282-7411
(440) 282-7419

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35-084892
OH
207Q00000X
Family Medicine Physician
Primary
35.084892
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000345924
ANTHEM
OH
01
1003027
QUALCHOICE
OH
05
2502125
OH
01
341908694031
CARESOURCE
OH
01
7475629
AETNA
OH
Enumeration date
03/31/2006
Last updated
02/05/2010
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