Provider Demographics
NPI:1710117338
Name:MICHEL, MONICA
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 SEVERENCE CIRCLE
Mailing Address - Street 2:APT 406
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118
Mailing Address - Country:US
Mailing Address - Phone:718-598-8402
Mailing Address - Fax:
Practice Address - Street 1:10900 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-476-7155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2086000000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery