Deross, Anthony L

Deross, Anthony L is an individual health care provider with primary practice located at 11100 Euclid Ave , Cleveland OH 44106-1716. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Deross, Anthony L can be contacted via phone (216) 844-7874.

Contact Information

Primary practice address
11100 Euclid Ave Cleveland OH 44106-1716
Phone: (216) 844-7874
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 229244 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 35-095425 Ohio

Profile Details

NPI number 1992755540
LBN Legal business name Deross, Anthony L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated May 25th, 2011 - about 13 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 1992755540 NPPES
Ohio MEDICAID 3051852
Ohio MEDICAID 2122634
Ohio MEDICAID 1025751090001

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