MEDICARE: BAHAR LADERIAN

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	207RH0003X	Hematology & Oncology Physician	35.139891	OH

General Provider Information

NPI Number	:	1992123970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAHAR LADERIAN

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE DEPT OF
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-1005
Country	:	US
Telephone Number	:	999-999-9999
Fax Number	:

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

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	07/06/2020

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Directions to “ BAHAR LADERIAN ” Practice Location

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