Provider Demographics
NPI:1881187771
Name:KIEFFER, ROBERT EARL I
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EARL
Last Name:KIEFFER
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3932
Mailing Address - Country:US
Mailing Address - Phone:216-441-0200
Mailing Address - Fax:
Practice Address - Street 1:8411 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-3932
Practice Address - Country:US
Practice Address - Phone:216-441-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator