MEDICARE: RICHARD C HARLAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	35066001	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000353558	OTHER	OH	ANTHEM BC/BS
2	351424	OTHER	OH	WELLCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164477972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD C HARLAN MD

Provider Business Mailing Address
First Line	:	10654 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5411
Country	:	US
Telephone Number	:	216-941-1044
Fax Number	:	216-941-5848

Provider Business Practice Location Address
First Line	:	10654 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5411
Country	:	US
Telephone Number	:	216-941-1044
Fax Number	:	216-941-5848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	01/13/2009

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Directions to “ RICHARD C HARLAN MD” Practice Location

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