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General NPI Number Information
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NPI Number | 1386107530
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Entity Type | Individual
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Provider Name | NADINE-STELLA E ACHENJANG MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 12540 EDGEWATER DR APT 1505
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City | CLEVELAND
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State | OH
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Zip | 44107-1665
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Country | US
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Telephone | 859-319-7412
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 57.248164
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 77012
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 35.144806
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License Number State | OH
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