Provider Demographics
NPI:1639139181
Name:CUA, JOHN V (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:V
Last Name:CUA
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 1:26908 DETROIT RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2398
Mailing Address - Country:US
Mailing Address - Phone:440-892-6406
Mailing Address - Fax:440-617-0884
Practice Address - Street 1:9937 SHADY LN
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3010
Practice Address - Country:US
Practice Address - Phone:216-741-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.034096207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000142982OtherANTHEM BC BS
OH00040007120OtherAETNA
OH2775298710001OtherMEDICAL MUTUAL
OHP00285914OtherRR MEDICARE
OH0214299Medicaid
OH111531117OtherTRAVELERMEDICARE RAILROAD
OH000000142982OtherANTHEM BC BS
OH0214299Medicaid
OH7338441Medicare PIN