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Individual

DR. MODISH JEAN LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
23250 CHAGRIN BLVD, 110, BEACHWOOD, OH 44122-5470
(216) 591-1862
(216) 591-9399
Mailing address
23250 CHAGRIN BLVD, 110, BEACHWOOD, OH 44122-5470
(216) 591-1862
(216) 591-9399

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35049505
OH

Other

Enumeration date
02/06/2007
Last updated
07/08/2007
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