Provider Demographics
NPI:1639149115
Name:GROSS-SAWICKA, EWA M (MD)
Entity Type:Individual
Prefix:DR
First Name:EWA
Middle Name:M
Last Name:GROSS-SAWICKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EWA
Other - Middle Name:M
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:440-250-2070
Mailing Address - Fax:440-356-1904
Practice Address - Street 1:960 CLAGUE RD STE 3201
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1588
Practice Address - Country:US
Practice Address - Phone:440-250-2070
Practice Address - Fax:440-250-2071
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2118014Medicaid
G92396Medicare UPIN
OH2118014Medicaid