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NPI Code Detail

MEDICARE: DR. JEFFREY M P SIMINOVITCH M.D.

MEDICARE:  DR. JEFFREY M P SIMINOVITCH  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
1208800000XUrology Physician35. 044819OH

Other Identifiers

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

General Provider Information

NPI Number : 1598754293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY M P SIMINOVITCH M.D.
Provider Business Mailing Address
First Line : 36060 EUCLID AVE STE 102
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-4661
Country : US
Telephone Number : 440-946-4555
Fax Number : 440-946-6252
Provider Business Practice Location Address
First Line : 36060 EUCLID AVE STE 102
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-4661
Country : US
Telephone Number : 440-946-4555
Fax Number : 440-946-6252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 05/11/2023

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