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NPI Code Detail

MEDICARE: DR. JENNIFER REBECCA BOHL M.D.

MEDICARE: DR. JENNIFER REBECCA BOHL 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
1207W00000XOphthalmology Physician35-087264OH

General Provider Information

NPI Number : 1831203181
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER REBECCA BOHL M.D.
Provider Business Mailing Address
First Line : 1001 LAKESIDE AVE E
Second Line : #1200
City : CLEVELAND
State : OH
Zip : 44114-1158
Country : US
Telephone Number : 216-479-5541
Fax Number : 216-479-5554
Provider Business Practice Location Address
First Line : 10 SEVERANCE CIR
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-1533
Country : US
Telephone Number : 216-621-5600
Fax Number : 216-297-2678
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 06/20/2008

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