Provider Demographics
NPI:1033177571
Name:GETACHEW, ESKENDER (MD)
Entity Type:Individual
Prefix:
First Name:ESKENDER
Middle Name:
Last Name:GETACHEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 931041
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-1372
Mailing Address - Country:US
Mailing Address - Phone:614-854-0300
Mailing Address - Fax:614-854-0302
Practice Address - Street 1:1050 KINGSMILL PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1143
Practice Address - Country:US
Practice Address - Phone:614-505-7270
Practice Address - Fax:614-505-7249
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0862012084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2569313Medicaid
OH2569313Medicaid
OHP00618831Medicare PIN
OH4160766Medicare PIN
OHP00256086OtherTRAVELERS MEDICARE
OH261086216OtherPPO NEXT
OH261086216OtherCIGNA
131906Medicare UPIN
OH2569313Medicaid
OH4160766Medicare PIN
OH4160766OtherMEDICARE ID - TYPE UNSPECIFIED