Healthcare Provider Details

I. General information

NPI: 1760598601
Provider Name (Legal Business Name): MICHAEL E MENEFEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/09/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # CA-60
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # CA-60
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-7920
  • Fax:
Mailing address:
  • Phone: 216-445-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35C.000929
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: