Healthcare Provider Details

I. General information

NPI: 1699159665
Provider Name (Legal Business Name): JEAN CLAUDE UWAMUNGU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2015
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE MAILSTOP LAKESIDE 5038
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-795-8816
  • Fax: 216-844-8954
Mailing address:
  • Phone: 216-795-8816
  • Fax: 216-844-8954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.152542
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.152542
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: