Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 35.024288 | OH |
NPI | 1003929761 |
---|---|
Provider Name | Sheldon D Kamen |
First Address | Pepper Pike, OH 44124-5281 |
Second Address | Pepper Pike, OH 44124-5281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 23/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0055596 | (05) | OH |
F02908 | (02) | OH |