Healthcare Provider Details

I. General information

NPI: 1518353507
Provider Name (Legal Business Name): MICHELLE KUZNICKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 01/24/2023
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # NA-23
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-938-2618
  • Fax:
Mailing address:
  • Phone: 216-444-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35135915
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number35135915
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: