Individual
DR. JUSTIN YAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO.
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-1636
(216) 844-7106
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.010724
OH
207R00000X
Internal Medicine Physician
5101014747
MI
207R00000X
Internal Medicine Physician
OS10221
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074341
—
OH
01
—
P01113633
MEDICARE RAILROAD
OH
Enumeration date
03/26/2007
Last updated
01/24/2013
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