Provider Demographics
NPI:1902869605
Name:STEHURA, MICHELLE JAWORSKI (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JAWORSKI
Last Name:STEHURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:ANGELIQUE
Other - Last Name:JAWORSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD. FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:216-383-6950
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-368-2482
Practice Address - Fax:216-844-1810
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-093179207ZP0102X, 207ZC0500X, 207QS0010X, 207ZP0102X
OH35093179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC268436Medicaid
OH0085022Medicaid
H206591Medicare PIN
SCH73724Medicare UPIN
SC268436Medicaid