MEDICARE: SHELLY DEBBIE PESICK-CAINE 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	208000000X	Pediatrics Physician	35056188	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000026098	OTHER	OH	UNICARE LIFE AND HEALTH
2	380761	OTHER	OH	WELLCARE
3	000000026098	OTHER	OH	ANTHEM BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	R56188	OTHER	OH	SUMMARE HEALTH PLAN

General Provider Information

NPI Number	:	1427059567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLY DEBBIE PESICK-CAINE M.D.

Provider Business Mailing Address
First Line	:	6775 RIDGECLIFF DR
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-3884
Country	:	US
Telephone Number	:	440-248-2481
Fax Number	:

Provider Business Practice Location Address
First Line	:	6559 WILSON MILLS RD
Second Line	:	BLDG D SUITE 101
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-6402
Country	:	US
Telephone Number	:	440-473-0010
Fax Number	:	440-460-2812

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/30/2011

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Directions to “ SHELLY DEBBIE PESICK-CAINE M.D.” Practice Location

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