Provider Demographics
NPI:1902824527
Name:MODLIN, SHERYL F (MD)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:F
Last Name:MODLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-6805
Mailing Address - Country:US
Mailing Address - Phone:216-444-2200
Mailing Address - Fax:216-636-2043
Practice Address - Street 1:20000 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-6805
Practice Address - Country:US
Practice Address - Phone:216-491-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.064537207L00000X
OH35-064537207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017013500001Medicaid
MI1902824527OtherMICHIGAN MEDICAID
OH0926789Medicaid
OH4337359OtherAETNA
OH000000221067OtherUNISON
OH0583328OtherBCMH
OH363852OtherWELLCARE MEDICAID
OH000000516049OtherANTHEM
IN1902824527OtherINDIANA MEDICAID
OH727584OtherBUCKEYE MEDICAID
OH0926789Medicaid
OHMO0742016Medicare PIN
MI1902824527OtherMICHIGAN MEDICAID