Individual
MICHELLE K IDADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
9500 EUCLID AVE, MAIL CODE A40, CLEVELAND, OH 44195-0001
(216) 692-7239
(216) 692-7802
Mailing address
9500 EUCLID AVE, MAIL CODE A40, CLEVELAND, OH 44195-0001
(216) 445-7408
(216) 445-6255
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50.004077RX
OH
Other
Enumeration date
08/26/2014
Last updated
05/22/2019
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