Healthcare Provider Details

I. General information

NPI: 1891794608
Provider Name (Legal Business Name): THE CIRCULATORY CENTER OF CLEVELAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7050 ENGLE RD SUITE 102
CLEVELAND OH
44130-8406
US

IV. Provider business mailing address

397 CHURCHILL HUBBARD RD
YOUNGSTOWN OH
44505-1375
US

V. Phone/Fax

Practice location:
  • Phone: 440-234-5000
  • Fax: 440-234-2610
Mailing address:
  • Phone: 330-759-6750
  • Fax: 330-759-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: LINDSAY MCALLEN
Title or Position: CREDENTILING SPECIALIST
Credential:
Phone: 330-759-6750