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NPI Code Detail

MEDICARE: ROCKPORT MEDICAL CENTER INC

MEDICARE: ROCKPORT MEDICAL CENTER INC
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1538353966
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKPORT MEDICAL CENTER INC
Provider Business Mailing Address
First Line : 3665 W 117TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44111
Country : US
Telephone Number : 216-251-5464
Fax Number : 216-251-5964
Provider Business Practice Location Address
First Line : 3665 W 117TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5215
Country : US
Telephone Number : 216-251-5464
Fax Number : 216-251-5964
Authorized Official
Title or Position : PRESIDENT
Name : DR. ALBERT ANTHONEY MUSCA
Credential : M.D.
Telephone Number : 216-251-5464
Provider Enumeration Date : 08/29/2007
Last Update Date : 08/29/2007

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Directions to “ROCKPORT MEDICAL CENTER INC ” Practice Location

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