Provider Demographics
NPI:1164452454
Name:MEGERIAN, CLIFF A (MD)
Entity Type:Individual
Prefix:
First Name:CLIFF
Middle Name:A
Last Name:MEGERIAN
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-6000
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-081019207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2324827OtherBCMH
OH352262OtherWELLCARE
OHP00358814OtherRAILROAD MEDICARE
OH000000204730OtherUNISON
OH1001011OtherUHC
OH5997137OtherAETNA
OH000000506209OtherANTHEM
OH2324827Medicaid
OH732485OtherBUCKEYE
OH000000230047OtherANTHEM
OHF61454Medicare UPIN
OH000000204730OtherUNISON
OH5997137OtherAETNA