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1578509964

NPI Code Detail

MEDICARE: JANE E CORTEVILLE MD

MEDICARE: JANE E CORTEVILLE 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	207SG0201X	Clinical Genetics (M.D.) Physician	35074300	OH
2	207V00000X	Obstetrics & Gynecology Physician	35074300	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	:	1578509964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE E CORTEVILLE MD

Provider Business Mailing Address
First Line	:	24701 EUCLID AVE
Second Line	:	3RD FLOOR
City	:	EUCLID
State	:	OH
Zip	:	44117-1714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1716
Country	:	US
Telephone Number	:	216-844-3941
Fax Number	:

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	12/16/2020

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Directions to “ JANE E CORTEVILLE MD” Practice Location

Language	Start Address	Practice Location

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