Healthcare Provider Details

I. General information

NPI: 1821065087
Provider Name (Legal Business Name): BROOKE E HOHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

33850 LAKE RD
AVON LAKE OH
44012-1012
US

V. Phone/Fax

Practice location:
  • Phone: 216-714-8675
  • Fax:
Mailing address:
  • Phone: 440-506-8721
  • Fax: 440-506-8721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35087161H
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: