Healthcare Provider Details

I. General information

NPI: 1124567466
Provider Name (Legal Business Name): VINCENT M MONNIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 CORNELL ROAD
CLEVELAND OH
44106
US

IV. Provider business mailing address

16300 ALDERSYDE DR
SHAKER HEIGHTS OH
44120-2512
US

V. Phone/Fax

Practice location:
  • Phone: 216-368-6613
  • Fax: 216-368-1357
Mailing address:
  • Phone: 216-548-6580
  • Fax: 216-368-1357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number35.051006
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: