MEDICARE: DR. EMILIA CALVARESI MD, PHD

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	207ZP0007X	Molecular Genetic Pathology (Pathology) Physician	35.142057	OH
2	207ZC0006X	Clinical Pathology Physician	10964148-1205	UT

General Provider Information

NPI Number	:	1942735238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILIA CALVARESI MD, PHD

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # LL2-134
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0002
Country	:	US
Telephone Number	:	216-444-9484
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # LL-134
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-1100
Country	:	US
Telephone Number	:	216-444-9484
Fax Number	:

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

Provider Enumeration Date	:	04/25/2017
Last Update Date	:	08/04/2021

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