Basic Information
| Provider Information | |||||||||
| NPI: | 1790881258 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNAUER | ||||||||
| FirstName: | KENT | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 74594 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441940002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168961850 | ||||||||
| FaxNumber: | 2168961851 | ||||||||
| Practice Location | |||||||||
| Address1: | 3909 ORANGE PL STE 2300 | ||||||||
| Address2: | |||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441224468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163830100 | ||||||||
| FaxNumber: | 2163836481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 05/21/2008 | ||||||||
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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 | 207R00000X | 35050023 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.