Individual
TERRY BANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
CLEVELAND CLINIC FAIRVIEW HOSPITAL 18101 LORAIN AVENUE, EMERGENCY SERVICES, CLEVELAND, OH 44111-5612
(216) 476-7312
Mailing address
CLEVELAND CLINIC FAIRVIEW HOSPITAL 18101 LORAIN AVENUE, EMERGENCY SERVICES, CLEVELAND, OH 44111-5612
(216) 476-7312
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
50.000914RX
OH
207P00000X
Emergency Medicine Physician
50000914
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970025543
MEDICARE TRAVELERS RR-GA
OH
Enumeration date
05/28/2006
Last updated
07/02/2018
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