MEDICARE: DR. ADAM J HEDAYA 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	208VP0014X	Interventional Pain Medicine Physician	35094290	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01368707	OTHER	OH	RAILROAD

General Provider Information

NPI Number	:	1528171113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM J HEDAYA MD

Provider Business Mailing Address
First Line	:	PO BOX 241565
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-8565
Country	:	US
Telephone Number	:	440-306-3200
Fax Number	:	440-574-0009

Provider Business Practice Location Address
First Line	:	300 ALLEN BRADLEY DR
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-6130
Country	:	US
Telephone Number	:	440-306-3200
Fax Number	:	440-614-0159

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	06/27/2024

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