Basic Information
| Provider Information | |||||||||
| NPI: | 1538152772 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAISER | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3605 WARRENSVILLE CENTER ROAD | ||||||||
| Address2: | 1ST FLOOR NISC 9152 | ||||||||
| City: | SHAKER HTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162866260 | ||||||||
| FaxNumber: | 2162866341 | ||||||||
| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168447330 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2005 | ||||||||
| LastUpdateDate: | 05/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35-065743 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LC0200X | 35-065743 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000225216 | 01 | OH | UNISON | OTHER | 0583328 | 01 | OH | BCMH | OTHER | 751157 | 01 | OH | BUCKEYE MEDICAID | OTHER | 0127339 | 05 | OH | MEDICAID | 1538152772 | 01 | MI | MICHIGAN MEDICAID | OTHER | 050075360 | 01 | OH | RAILROAD MEDICARE | OTHER | 000000142261 | 01 | OH | ANTHEM BCBS | OTHER | 414985 | 01 | OH | WELLCARE MEDICAID | OTHER | 5225680 | 01 | OH | AETNA | OTHER | P00420603 | 01 | OH | RAILROAD MEDICARE | OTHER | 000000538624 | 01 | OH | ANTHEM | OTHER |