Healthcare Provider Details
I. General information
NPI: 1568825818
Provider Name (Legal Business Name): ADAM HWAN BATES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2016
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 EUCLID AVE # E19
CLEVELAND OH
44195-1900
US
IV. Provider business mailing address
9500 EUCLID AVE # E19
CLEVELAND OH
44195-0001
US
V. Phone/Fax
- Phone: 216-445-9132
- Fax:
- Phone: 216-445-9132
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 35.135330 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A2900X |
| Taxonomy | Neurocritical Care Physician |
| License Number | 35.135330 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: