Healthcare Provider Details
I. General information
NPI: 1134437577
Provider Name (Legal Business Name): BEWELL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2010
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3681 GREEN RD SUITE 410
CLEVELAND OH
44122-5726
US
IV. Provider business mailing address
3681 GREEN RD SUITE 410
CLEVELAND OH
44122-5726
US
V. Phone/Fax
- Phone: 216-378-0888
- Fax: 216-360-9712
- Phone: 216-378-0888
- Fax: 216-360-9712
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RONALD
GOLOVAN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 216-696-2205