Healthcare Provider Details

I. General information

NPI: 1255712659
Provider Name (Legal Business Name): ROOPA ANMOLSINGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # X10
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # X10
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-6801
  • Fax: 164-458-7622
Mailing address:
  • Phone: 216-444-6801
  • Fax: 164-458-7622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD464915
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number35.146507
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: