Healthcare Provider Details

I. General information

NPI: 1003240938
Provider Name (Legal Business Name): ADITI YADAV M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195
US

IV. Provider business mailing address

9500 EUCLID AVENUE CLEVELAND CLINIC CHILDREN'S HOSPITAL, R4
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-5686
  • Fax: 216-636-0009
Mailing address:
  • Phone: 216-445-5686
  • Fax: 216-636-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number57.028918
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number57.028918
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: