DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: VICTORIA STORM SHEPHERD PA

MEDICARE: VICTORIA STORM SHEPHERD PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant50001447OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
29357511OTHEROHMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150001447OTHEROHLICENSE

General Provider Information

NPI Number : 1396707311
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA STORM SHEPHERD PA
Provider Business Mailing Address
First Line : PO BOX 391405
Second Line :
City : SOLON
State : OH
Zip : 44139-8405
Country : US
Telephone Number : 216-496-4433
Fax Number : 440-834-1902
Provider Business Practice Location Address
First Line : 4180 WARRENSVILLE CENTER RD
Second Line : 120
City : BEACHWOOD
State : OH
Zip : 44122-7024
Country : US
Telephone Number : 440-834-1833
Fax Number : 440-834-1902
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 12/29/2009

Similar Medicare Providers

1114900560 — KATHRYN A KRAUS PA-C
Practice Location Address:
4110 WARRENSVILLE CENTER RD
BEACHWOOD, OH
44122-7024
Practice Phone: 216-491-6000
Practice Fax:
1003899451 — FRANKIE ELIZABETH WALLER PA-C
Practice Location Address:
4110 WARRENSVILLE CENTER RD
BEACHWOOD, OH
44122-7024
Practice Phone: 216-491-6000
Practice Fax:
1891767711 — JAMIE L FERENCAK PA
Practice Location Address:
4110 WARRENSVILLE CENTER RD
BEACHWOOD, OH
44122-7024
Practice Phone: 216-491-6000
Practice Fax:
1841262458 — TODD A CSORBA D.O.
Practice Location Address:
4110 WARRENSVILLE CENTER RD
BEACHWOOD, OH
44122-7024
Practice Phone: 216-491-7483
Practice Fax: 216-491-6549
1629040233 — CAROL WEBER PA-C
Practice Location Address:
4110 WARRENSVILLE CENTER RD
BEACHWOOD, OH
44122-7024
Practice Phone: 216-491-6000
Practice Fax:
1528030137 — PATRICK T O'BRIEN D.O.
Practice Location Address:
4110 WARRENSVILLE CENTER RD
BEACHWOOD, OH
44122-7024
Practice Phone: 216-491-7483
Practice Fax: 216-491-6549
1912970294 — DENNIS E. KANE D.O.
Practice Location Address:
4110 WARRENSVILLE CENTER RD
BEACHWOOD, OH
44122-7024
Practice Phone: 216-491-7483
Practice Fax: 216-491-6549

Directions to “ VICTORIA STORM SHEPHERD PA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.