Basic Information
| Provider Information | |||||||||
| NPI: | 1235183435 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BISKER | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3700 PARK EAST DR | ||||||||
| Address2: | SUITE 450 | ||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441224305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552921401 | ||||||||
| FaxNumber: | 8663968340 | ||||||||
| Practice Location | |||||||||
| Address1: | 3700 PARK EAST DR | ||||||||
| Address2: | SUITE 450 | ||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441224305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552921401 | ||||||||
| FaxNumber: | 8663968340 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 05/27/2016 | ||||||||
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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 | 2085N0904X | ME0031722 | FL | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085R0202X | ME0031722 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 131808-1 | NY | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 419229 | PA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 21975 | KY | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 186465 | 01 | AMERIGROUP | OTHER | ME31722 | 01 | FL | WORKERS' COMP | OTHER | 696678 | 01 | CIGNA | OTHER | 7100200600 | 05 | KY | MEDICAID | P00402367 | 01 | FL | RR MEDICARE FRL | OTHER | 0773177 | 05 | OH | MEDICAID | 097830500 | 05 | DC | MEDICAID | 1028868150001 | 05 | PA | MEDICAID | 1235183435 | 05 | MI | MEDICAID | O55404473 | 01 | CHAMPUS | OTHER | 267034800 | 05 | FL | MEDICAID | 29167 | 01 | FL | BCBS | OTHER |