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NPI Code Detail

MEDICARE: DR. JARED ANKERMAN M.D.

MEDICARE: DR. JARED ANKERMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician35.137231OH

General Provider Information

NPI Number : 1538519764
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JARED ANKERMAN M.D.
Provider Business Mailing Address
First Line : 11851 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3016
Country : US
Telephone Number : 529-216-7125
Fax Number :
Provider Business Practice Location Address
First Line : 11851 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3016
Country : US
Telephone Number : 216-529-7125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2016
Last Update Date : 10/06/2019

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