MEDICARE: JENNIFER JEROMIN MD

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
1	207P00000X	Emergency Medicine Physician	35066775J	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558322701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JEROMIN MD

Provider Business Mailing Address
First Line	:	17605 WING RD
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44023
Country	:	US
Telephone Number	:	440-543-5249
Fax Number	:

Provider Business Practice Location Address
First Line	:	17605 WING RD
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44023-2613
Country	:	US
Telephone Number	:	440-543-5249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	03/04/2016

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