Healthcare Provider Details

I. General information

NPI: 1043747454
Provider Name (Legal Business Name): UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

PO BOX 772930
DETROIT MI
48277-2930
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-8447
  • Fax:
Mailing address:
  • Phone: 216-844-8447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY SCHILLERO
Title or Position: DIRECTOR, FP&A
Credential:
Phone: 216-767-8141