Provider Demographics
NPI:1295725075
Name:STUBBS, CAILIN M (MD)
Entity type:Individual
Prefix:DR
First Name:CAILIN
Middle Name:M
Last Name:STUBBS
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 1:7757 AUBURN RD STE 15
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9604
Mailing Address - Country:US
Mailing Address - Phone:403-500-8324
Mailing Address - Fax:440-579-0191
Practice Address - Street 1:36000 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4625
Practice Address - Country:US
Practice Address - Phone:403-500-8324
Practice Address - Fax:440-579-0191
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070301S207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2080733Medicaid
OHG87709Medicare UPIN
OH0865862Medicare ID - Type Unspecified
OH0865861Medicare ID - Type Unspecified
OH2080733Medicaid