Provider Demographics
NPI:1275568495
Name:BARON, ELMA D (MD)
Entity Type:Individual
Prefix:
First Name:ELMA
Middle Name:D
Last Name:BARON
Suffix:
Gender:F
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:216-844-8200
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-084878207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000221001OtherUNISON
NY02922998OtherNEW YORK MEDICAID
OH2522470Medicaid
OH7930662OtherAETNA
OH000000354268OtherANTHEM
OH000000523161OtherANTHEM
PA1020551090001OtherPENNSYLVANIA MEDICAID
363341OtherWELLCARE
OHP00411926OtherRAILROAD MEDICARE
OHP00323176OtherRAILROAD MEDICARE
743932OtherBUCKEYE
OH000000523161OtherANTHEM
743932OtherBUCKEYE
OH2522470Medicaid