Provider Demographics
NPI:1639101371
Name:SIMON, HELGE U (MD)
Entity Type:Individual
Prefix:
First Name:HELGE
Middle Name:U
Last Name:SIMON
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 1:36060 EUCLID AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4661
Mailing Address - Country:US
Mailing Address - Phone:440-269-8346
Mailing Address - Fax:440-975-5763
Practice Address - Street 1:36060 EUCLID AVE STE 107
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4661
Practice Address - Country:US
Practice Address - Phone:440-269-8346
Practice Address - Fax:440-975-5763
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.079840207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2481425Medicaid
OHI06061Medicare UPIN
OH2481425Medicaid