John J Baniewicz, MD
Internal Medicine in Mentor, OH. Individual provider (NPI-1).
NPI number1285740530
StatusActive
Last updated in NPPESMar 1, 2021
Details
- NPI
- 1285740530
- Entity type
- Individual (NPI-1)
- Name
- John J Baniewicz
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 21, 2006
- Certification date
- Mar 1, 2021
- Last updated
- Mar 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 35-058500 | OH | Yes |
Practice location
9485 Mentor AveSte 210
Mentor, OH 44060
Phone 440-205-5835 · Fax 440-205-5735
Mailing address
36000 Euclid AveMso
Willoughby, OH 44094
Phone 440-953-6082 · Fax 440-953-6101
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