Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35067017S | OH |
NPI | 1124084207 |
---|---|
Provider Name | Nicholas G Smedira |
First Address | Independence, OH 44131-2139 |
Second Address | Cleveland, OH 44195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 07/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0989604 | (05) | OH |
F86116 | (02) | OH |