1578752200 NPI number — GERMAN L.NERI, MD

Table of content: (NPI 1578752200)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578752200 NPI number — GERMAN L.NERI, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GERMAN L.NERI, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GERMAN L NERI, MD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578752200
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14601 DETROIT AVE STE 730
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44107-4251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-226-3577
Provider Business Mailing Address Fax Number:
216-226-3599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14601 DETROIT AVE STE 730
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44107-4251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-226-3577
Provider Business Practice Location Address Fax Number:
216-226-3599
Provider Enumeration Date:
10/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NERI
Authorized Official First Name:
GERMAN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
216-226-3577

Provider Taxonomy Codes

  • Taxonomy code: 173000000X , with the licence number:  35-032276 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000127968 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 100-38-4219-001 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000127968 . This is a "ANTHEM SENIOR ADVANTAGE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 352453 . This is a "WELLCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0178918 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100-38-4219-00 . This is a "CAREWORKS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 100384219009 . This is a "MEDICAL MUTUAL OF OHIO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 100-38-4219-00 . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: CG4786 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com