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Individual

DR. SINA BENJAMIN ESRAEILIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1491 LLOYD RD, WICKLIFFE, OH 44092-2319
(440) 585-1616
Mailing address
23485 WENDOVER DR, BEACHWOOD, OH 44122-1448
(440) 585-1616

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36.002709
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000116138
ANTHEM BCBS
OH
05
0882540
OH
01
34-1724510-002
MEDICAL MUTUAL OF OHIO
OH
Enumeration date
09/25/2006
Last updated
07/08/2007
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