Healthcare Provider Details

I. General information

NPI: 1659892719
Provider Name (Legal Business Name): EMILY WESSON KANE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10524 EUCLID AVE STE 8107
CLEVELAND OH
44106-2205
US

IV. Provider business mailing address

604 DAVIS CIR SW
HUNTSVILLE AL
35801-5014
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3658
  • Fax: 216-844-4741
Mailing address:
  • Phone: 256-634-6932
  • Fax: 256-290-7351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL51246
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35.139016
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: