MEDICARE: DR. GERMAN L NERI M.D.

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
1	207RC0000X	Cardiovascular Disease Physician	35-032276	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00717465	OTHER	OH	RAILROAD CARE

General Provider Information

NPI Number	:	1407886898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERMAN L NERI M.D.

Provider Business Mailing Address
First Line	:	14601 DETROIT AVE STE 730
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4251
Country	:	US
Telephone Number	:	216-226-3577
Fax Number	:	216-226-3599

Provider Business Practice Location Address
First Line	:	14601 DETROIT AVE STE 730
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4251
Country	:	US
Telephone Number	:	216-226-3577
Fax Number	:	216-226-3599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/22/2011

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