Provider Demographics
NPI:1548223761
Name:SALEWSKI, JONATHAN H (DO)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:H
Last Name:SALEWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4804 HICKORY NUT LN
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-4640
Mailing Address - Country:US
Mailing Address - Phone:216-447-9229
Mailing Address - Fax:216-447-8384
Practice Address - Street 1:7007 POWERS BLVD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5437
Practice Address - Country:US
Practice Address - Phone:440-743-4333
Practice Address - Fax:440-743-4334
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-003405207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0536567Medicaid
OH376112OtherANTHEM BCBS
OH376112OtherANTHEM BCBS
SA0562491Medicare PIN