Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36 002378 | OH |
NPI | 1083647903 |
---|---|
Provider Name | Stephen H. Pearl |
First Address | Lyndhurst, OH 44124-4041 |
Second Address | Lyndhurst, OH 44124-4041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 12/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0694717 | (05) | OH |
T80649 | (02) | OH |