Healthcare Provider Details
I. General information
NPI: 1689353112
Provider Name (Legal Business Name): ZURABI ZAALISHVILI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 EUCLID AVE # JJ24
CLEVELAND OH
44195-0001
US
IV. Provider business mailing address
9500 EUCLID AVE # JJ24
CLEVELAND OH
44195-0001
US
V. Phone/Fax
- Phone: 216-444-2200
- Fax:
- Phone: 216-444-2200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 57.254608 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: