Basic Information
| Provider Information | |||||||||
| NPI: | 1891755591 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FILIATRAUT | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | ZEPHERE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26908 DETROIT RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | WESTLAKE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441452398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406171823 | ||||||||
| FaxNumber: | 4406170884 | ||||||||
| Practice Location | |||||||||
| Address1: | 2535 HALE ST | ||||||||
| Address2: | SUITE | ||||||||
| City: | AVON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440111856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409348810 | ||||||||
| FaxNumber: | 4409348811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2006 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 34008276 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2659529 | 05 | OH | MEDICAID | BF8829840 | 01 | OH | DEA # | OTHER | 34008276 | 01 | OH | LICENSE # | OTHER |