Provider Demographics
NPI:1548285836
Name:COSSLER, NANCY J (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:COSSLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-059172207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0767246Medicaid
OH221186OtherUNISON
OH000000509155OtherANTHEM
OH4322084OtherAETNA
OH000000221186OtherUNISON
OH363447OtherWELLCARE
OHP00228747OtherRAILROAD MEDICARE
OH750523OtherBUCKEYE
OH750523OtherBUCKEYE
OH4322084OtherAETNA
OH221186OtherUNISON
OHP00771660Medicare PIN