Healthcare Provider Details

I. General information

NPI: 1871869404
Provider Name (Legal Business Name): ALIA NICOLE WHITMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALIA NICOLE GUILLAUME

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # E19
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # E19
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-9175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.123914
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35.123914
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: