Healthcare Provider Details

I. General information

NPI: 1083385181
Provider Name (Legal Business Name): ASSURE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 W 25TH ST STE 2E
CLEVELAND OH
44113-3108
US

IV. Provider business mailing address

10290 ALLIANCE RD
BLUE ASH OH
45242-4710
US

V. Phone/Fax

Practice location:
  • Phone: 216-696-4140
  • Fax: 216-363-2058
Mailing address:
  • Phone: 216-696-4140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID MILLER
Title or Position: VP OPERATIONS & STRATEGY
Credential:
Phone: 740-360-8976