Healthcare Provider Details

I. General information

NPI: 1598142622
Provider Name (Legal Business Name): MAGDY ESKANDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2015
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29000 CENTER RIDGE RD ST. JOHN MEDICAL CENTER
WESTLAKE OH
44145-5219
US

IV. Provider business mailing address

29000 CENTER RIDGE RD ST. JOHN MEDICAL CENTER
WESTLAKE OH
44145-5219
US

V. Phone/Fax

Practice location:
  • Phone: 440-835-8000
  • Fax:
Mailing address:
  • Phone: 440-835-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34.013822
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: