Provider Demographics
NPI:1063500981
Name:KAFFEN, SHELDON (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:
Last Name:KAFFEN
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 1:4200 WARRENSVILLE CTR RD
Mailing Address - Street 2:#451 BLDG A
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-752-0366
Mailing Address - Fax:216-752-1909
Practice Address - Street 1:4200 WARRENSVILLE CTR RD
Practice Address - Street 2:#451 BLDG A
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-752-0366
Practice Address - Fax:216-752-1909
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH22983207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0071774Medicaid
KA0116913Medicare ID - Type Unspecified
A70304Medicare UPIN