Healthcare Provider Details

I. General information

NPI: 1578343000
Provider Name (Legal Business Name): MS. ALEXANDRIA D THURMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. ALEXANDRIA THURMAN

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 EUCLID AVE
CLEVELAND OH
44103-3736
US

IV. Provider business mailing address

4753 WALFORD RD APT 14
WARRENSVILLE HEIGHTS OH
44128-7266
US

V. Phone/Fax

Practice location:
  • Phone: 216-432-7200
  • Fax:
Mailing address:
  • Phone: 330-556-2927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number207QA0000X
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: