Provider Demographics
NPI:1881629111
Name:ELTOMEY, ATEF A (MD)
Entity Type:Individual
Prefix:DR
First Name:ATEF
Middle Name:A
Last Name:ELTOMEY
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 1:18099 LORAIN AVE
Mailing Address - Street 2:SUITE 425
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5610
Mailing Address - Country:US
Mailing Address - Phone:216-252-6330
Mailing Address - Fax:216-252-6819
Practice Address - Street 1:18099 LORAIN AVE
Practice Address - Street 2:SUITE 425
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5610
Practice Address - Country:US
Practice Address - Phone:216-252-6330
Practice Address - Fax:216-252-6819
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH050589207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0557713Medicaid
OH350987OtherWELLCARE
OH341542312152OtherCARESOURCE
OHP00437212OtherRAILROAD CARE
OH000000517252OtherANTHEM BC/BS
OH746799OtherBCHP
OHP00705927OtherRAILROAD CARE
OH746799OtherBCHP
OH0623622Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
OHP00705927OtherRAILROAD CARE
A17628Medicare UPIN