Provider Demographics
NPI:1144296856
Name:PEARSE, STEVEN CRAIG (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:CRAIG
Last Name:PEARSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24651 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5635
Mailing Address - Country:US
Mailing Address - Phone:440-895-5056
Mailing Address - Fax:440-333-2935
Practice Address - Street 1:29099 HEALTH CAMPUS DR
Practice Address - Street 2:STE 375
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5255
Practice Address - Country:US
Practice Address - Phone:216-529-7100
Practice Address - Fax:216-529-7749
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046000P208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
9273172OtherGROUP MEDICARE
0119204OtherGROUP MEDICAID
3610861OtherGROUP ASC MEDICARE
34-1783789OtherGROUP TAX ID
4007681OtherAETNA
000000274279OtherANTHEM
OH0457358Medicaid
10797386OtherCAQH
1780634279OtherGROUP NPI
102466OtherKAISER
CA4511OtherRR MEDICARE GROUP
D368301OtherMEDICARE IND DIAGNOSTICS
P00006989OtherRR MEDICARE INDIVIDUAL
000000274279OtherANTHEM
3610861OtherGROUP ASC MEDICARE