Provider Demographics
NPI:1366461709
Name:TAMBURRO, JOAN E (DO)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:TAMBURRO
Suffix:
Gender:F
Credentials:DO
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:2006-07-18
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-006393207N00000X, 207NP0225X
OH34.006393207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000343708OtherANTHEM
OH000000523167OtherANTHEM
OHP00267532OtherRAILROAD MEDICARE
000000221233OtherUNISON
PA1020821240001OtherPENNSYLVANIA MEDICAID
OH2064537Medicaid
OH5180049OtherAETNA
2064537OtherBCMH
364070OtherWELLCARE
740038OtherBUCKEYE
OHP01004266Medicare PIN
OH000000343708OtherANTHEM
740038OtherBUCKEYE
000000221233OtherUNISON