MEDICARE: AMERICAN MEDICAL LEGAL CONSULTANTS 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

General Provider Information

NPI Number	:	1649590423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL LEGAL CONSULTANTS INC

Provider Business Mailing Address
First Line	:	26400 GEORGE ZEIGER DR
Second Line	:	BUILDING 1 #116
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-7510
Country	:	US
Telephone Number	:	330-759-9119
Fax Number	:	330-759-3330

Provider Business Practice Location Address
First Line	:	11900 FAIRHILL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1062
Country	:	US
Telephone Number	:	330-759-9119
Fax Number	:	330-759-3330

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK SHOAG
Credential	:	MD
Telephone Number	:	330-759-9119

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	06/03/2010

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