MEDICARE: SETH EISENGART MD

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	208600000X	Surgery Physician	35043608	OH

General Provider Information

NPI Number	:	1821193244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH EISENGART MD

Provider Business Mailing Address
First Line	:	PO BOX 74585
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44194-0002
Country	:	US
Telephone Number	:	216-383-6776
Fax Number	:	216-383-6745

Provider Business Practice Location Address
First Line	:	27100 CHARDON RD STE 100
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-1116
Country	:	US
Telephone Number	:	440-347-9975
Fax Number	:	440-347-0930

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	01/16/2008

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Directions to “ SETH EISENGART MD” Practice Location

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