Provider Demographics
NPI:1366440778
Name:SEFFO, FIRAS (MD)
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:SEFFO
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:COMMUNITY HOSPITALS, LLC
Mailing Address - Street 2:PO BOX 39413
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44139
Mailing Address - Country:US
Mailing Address - Phone:440-523-5023
Mailing Address - Fax:440-523-5029
Practice Address - Street 1:LAKE HOSPITAL SYSTEMS EAST
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44044
Practice Address - Country:US
Practice Address - Phone:440-354-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.082074207R00000X
OH35-08-2074-S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2439838Medicaid
OH2439838Medicaid
OHSE4122503Medicare ID - Type Unspecified