Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 35-086339 | OH |
N | 208000000X | Pediatrician | 35-086339 | OH |
Y | 2080P0216X | Pediatric Rheumatologist | 35-086339 | OH |
NPI | 1205858792 |
---|---|
Provider Name | Elizabeth B Brooks |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 22/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000221208 | UNISON (01) | OH |
000000368506 | ANTHEM (01) | OH |
000000525884 | ANTHEM (01) | OH |
0017541850003 | (05) | PA |
2153851 | (05) | OH |
2153851 | BCMH (01) | OH |
363382 | WELLCARE (01) | OH |
7287047 | AETNA (01) | OH |
745885 | BUCKEYE (01) | OH |
H05461 | (02) | OH |