Healthcare Provider Details

I. General information

NPI: 1174943252
Provider Name (Legal Business Name): FREDERICK EDEM DOAMEKPOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY HOSPITALS AHUJA 3999 RICHMOND RD, DEPT. OF HOSPITAL MEDICINE
BEACHWOOD OH
44122
US

IV. Provider business mailing address

30680 BAINBRIDGE RD
SOLON OH
44139-2282
US

V. Phone/Fax

Practice location:
  • Phone: 216-593-5500
  • Fax:
Mailing address:
  • Phone: 440-542-5025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.132215
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.132215
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: