Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 35-045792 | OH |
NPI | 1275566184 |
---|---|
Provider Name | Barbara A Baetz-Greenwalt |
First Address | Mayfield Hts, OH 44124-6508 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000026882 | ANTHEM (01) | OH |
0656535 | (05) | OH |
1201917 | UHC (01) | OH |
5429031 | AETNA (01) | OH |
80063 | QUALCHOICE (01) | OH |
A82646 | (02) | OH |