Provider Demographics
NPI:1659301943
Name:LAVERTU, PIERRE (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:
Last Name:LAVERTU
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:UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Mailing Address - Street 2:11100 EUCLID AVENUE
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106
Mailing Address - Country:US
Mailing Address - Phone:218-844-4773
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-6000
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-049034207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4332566OtherAETNA
OHP00358803OtherRAILROAD MEDICARE
OH000000221265OtherUNISON
OH000000132433OtherANTHEM
OH363744OtherWELLCARE
OH1000525OtherUHC
OH000000506207OtherANTHEM
OH0700129Medicaid
OH10475493OtherAETNA
OH738070OtherBUCKEYE
OH000000506207OtherANTHEM
OH000000221265OtherUNISON
OHP00358803OtherRAILROAD MEDICARE
OHF07784Medicare UPIN