Provider Demographics
NPI:1487673265
Name:ZANOTTI, KRISTINE M (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:M
Last Name:ZANOTTI
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:216-844-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-077677207V00000X
OH77677207VX0201X
OH35.077677207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH364163OtherWELLCARE
OH7841156OtherAETNA
OH2187619Medicaid
OHP00320456OtherRAILROAD MEDICARE
OHP00382866OtherRAILROAD MEDICARE
OH000000509191OtherANTHEM
OH745991OtherBUCKEYE
OH000000221344OtherUNISON
OH1487673265Medicaid
OH000000509191OtherANTHEM
G23242Medicare UPIN