MEDICARE: DABMD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207P00000X	Emergency Medicine Physician
2	208000000X	Pediatrics Physician
3	207X00000X	Orthopaedic Surgery Physician
4	208D00000X	General Practice Physician
5	207R00000X	Internal Medicine Physician
6	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1376872960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DABMD

Provider Business Mailing Address
First Line	:	13916 CEDAR RD
Second Line	:
City	:	UNIVERSITY HTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-381-9000
Fax Number	:	216-381-2151

Provider Business Practice Location Address
First Line	:	13916 CEDAR RD
Second Line	:
City	:	UNIVERSITY HTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-381-9000
Fax Number	:	216-381-2151

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MARIA KATZAKIS
Credential	:
Telephone Number	:	216-381-9000

Provider Enumeration Date	:	12/10/2009
Last Update Date	:	04/23/2010

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Directions to “DABMD ” Practice Location

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