Basic Information
| Provider Information | |||||||||
| NPI: | 1396772174 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHLESINGER | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | PETER | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23625 COMMERCE PARK | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441225845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162555725 | ||||||||
| FaxNumber: | 8669049272 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 BELLEFONTAINE AVENUE | ||||||||
| Address2: | FSH RADIOLOGY, INC. | ||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458042800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192283335 | ||||||||
| FaxNumber: | 4192265064 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 01/05/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 35-023471 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 341212779020 | 01 | OH | MEDICAL MUTUAL | OTHER | 7784885 | 05 | OH | MEDICAID | 000000337521 | 01 | OH | ANTHEM | OTHER | 027978400 | 01 | FEDERAL BLACK LUNG | OTHER | 341212779007 | 01 | OH | MEDICAL MUTUAL | OTHER | 127593300 | 01 | US DEPARTMENT OF LABOR | OTHER | 300016816 | 01 | RAILROAD MEDICARE | OTHER |