Provider Demographics
NPI:1679526966
Name:YOEL S. ANOUCHI, M.D., INC.
Entity Type:Organization
Organization Name:YOEL S. ANOUCHI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOEL
Authorized Official - Middle Name:SHLOMO
Authorized Official - Last Name:ANOUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-460-0454
Mailing Address - Street 1:6803 MAYFIELD RD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2271
Mailing Address - Country:US
Mailing Address - Phone:440-460-0454
Mailing Address - Fax:440-460-0492
Practice Address - Street 1:6803 MAYFIELD RD
Practice Address - Street 2:SUITE 314
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2271
Practice Address - Country:US
Practice Address - Phone:440-460-0454
Practice Address - Fax:440-460-0492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-9112207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Not Answered207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01944904800OtherOH BUREAU OF WORKERS' COM
OH341856471026OtherCARESOURCE
OH0742941Medicaid
OH019449048014OtherMEDICAL MUTUAL OF OHIO
OH102628OtherKAISER
OH0000000140525OtherANTHEM BC/BS
OH019449048015OtherMEDICAL MUTUAL OF OHIO
OH019449048012OtherMEDICAL MUTUAL OF OHIO
OH0000000140525OtherANTHEM BC/BS
OH019449048014OtherMEDICAL MUTUAL OF OHIO
OH0742941Medicaid
OH102628OtherKAISER