Provider Demographics
NPI:1578341947
Name:DEAVER, AMERE
Entity Type:Individual
Prefix:
First Name:AMERE
Middle Name:
Last Name:DEAVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18410 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-2811
Mailing Address - Country:US
Mailing Address - Phone:216-647-7263
Mailing Address - Fax:
Practice Address - Street 1:18410 GLEN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-2811
Practice Address - Country:US
Practice Address - Phone:216-647-7263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health