Fagan, Kathleen M

Fagan, Kathleen M is an sole proprietor health care provider with primary practice located at 11100 Euclid Avenue , Cleveland OH 44106. She recently has only one registered license in Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine, which is considered as her primary health care specialty. Fagan, Kathleen M can be contacted via phone (216) 844-7700.

Contact Information

Primary practice address
11100 Euclid Avenue Cleveland OH 44106
Phone: (216) 844-7700
Fax: (216) 286-6299
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine 2083P0500X 35051175 Ohio

Profile Details

NPI number 1528005543
LBN Legal business name Fagan, Kathleen M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2006
Last updated Jun 12th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528005543 NPPES
Ohio MEDICAID 0607641
Ohio Other 000000221255
Ohio Other 4052254
Ohio Other 000000525944
Ohio Other 363514
Ohio Other 0607641
Ohio Other 745904

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