Healthcare Provider Details

I. General information

NPI: 1992030225
Provider Name (Legal Business Name): ROBERT JOHN BEARSS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

5920 TALLMADGE RD
ROOTSTOWN OH
44272-9749
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone: 330-325-6239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number082840
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: