Healthcare Provider Details

I. General information

NPI: 1043276280
Provider Name (Legal Business Name): HILLCREST DIAGNOSTIC PULMONARY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6780 MAYFIELD RD
CLEVELAND OH
44124
US

IV. Provider business mailing address

7500 OLD OAK BLVD
MIDDLEBURG HTS OH
44130-0000
US

V. Phone/Fax

Practice location:
  • Phone: 440-446-7423
  • Fax:
Mailing address:
  • Phone: 440-777-6300
  • Fax: 440-777-2330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ADI GERBLICH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 440-446-1423