Individual
MICHAEL W DEVEREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3192
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35-040322
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221409
UNISON
OH
01
—
000000510667
ANTHEM
OH
05
—
0340303
—
OH
01
—
0964431
AETNA
OH
01
—
130017944
MCR RR
—
01
—
363481
WELLCARE MEDICAID
OH
01
—
741862
BUCKEYE MEDICAID
OH
01
—
P00368430
MEDICARE RAILROAD
OH
Enumeration date
07/17/2006
Last updated
12/07/2020
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