Provider Demographics
NPI:1740211549
Name:RANASINGHE, ELIZABETH S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:S
Last Name:RANASINGHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23250 MERCANTILE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5928
Mailing Address - Country:US
Mailing Address - Phone:216-464-7878
Mailing Address - Fax:216-464-7879
Practice Address - Street 1:23250 MERCANTILE RD STE 130
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5928
Practice Address - Country:US
Practice Address - Phone:216-464-7878
Practice Address - Fax:216-464-7879
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-2054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0905588Medicaid
RA0716191OtherMEDICARE
OH0905588Medicaid