Healthcare Provider Details

I. General information

NPI: 1073527487
Provider Name (Legal Business Name): DARIA M DREBOTY-CERIMELE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15389 W HIGH ST
MIDDLEFIELD OH
44062-9236
US

IV. Provider business mailing address

36000 EUCLID AVE # MSO
WILLOUGHBY OH
44094-4625
US

V. Phone/Fax

Practice location:
  • Phone: 440-632-0594
  • Fax: 440-564-5719
Mailing address:
  • Phone: 440-953-6082
  • Fax: 440-953-6101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35085278
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: