Healthcare Provider Details

I. General information

NPI: 1710331632
Provider Name (Legal Business Name): BRANDON SCOTT TWARDY M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2016
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0002
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0002
US

V. Phone/Fax

Practice location:
  • Phone: 216-636-1873
  • Fax: 216-445-9446
Mailing address:
  • Phone: 216-636-1873
  • Fax: 216-445-9446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number35.139679
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: