MEDICARE: COMMUNITY INTERNISTS, 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
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548216815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY INTERNISTS, INC

Provider Business Mailing Address
First Line	:	6555 WILSON MILLS RD
Second Line	:	SUITE 103
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-3435
Country	:	US
Telephone Number	:	440-442-8313
Fax Number	:	440-442-8316

Provider Business Practice Location Address
First Line	:	6555 WILSON MILLS RD
Second Line	:	SUITE 103
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-3435
Country	:	US
Telephone Number	:	440-442-8313
Fax Number	:	440-442-8316

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LOREN S. KENDIS
Credential	:	M.D.
Telephone Number	:	440-442-8313

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	08/22/2020

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Directions to “COMMUNITY INTERNISTS, INC ” Practice Location

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