Basic Information
| Provider Information | |||||||||
| NPI: | 1417028556 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEN-MEIR | ||||||||
| FirstName: | AVIV | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7590 AUBURN ROAD | ||||||||
| Address2: | SUITE 014 | ||||||||
| City: | CONCORD TWP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440779176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403541899 | ||||||||
| FaxNumber: | 4403541845 | ||||||||
| Practice Location | |||||||||
| Address1: | 36100 EUCLID AVE STE 170 | ||||||||
| Address2: | |||||||||
| City: | WILLOUGHBY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440944475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406026737 | ||||||||
| FaxNumber: | 4409420316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2006 | ||||||||
| LastUpdateDate: | 02/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 35073480B | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2500314 | 05 | OH | MEDICAID | H227050 | 01 | OH | MEDICARE | OTHER |