Healthcare Provider Details

I. General information

NPI: 1912959016
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41201 SCHADDEN RD SUITE 2
ELYRIA OH
44035-2220
US

IV. Provider business mailing address

41201 SCHADDEN RD SUITE 2
ELYRIA OH
44035-2220
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-0401
  • Fax: 440-324-0405
Mailing address:
  • Phone: 440-324-0401
  • Fax: 440-324-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BELAGODU N KANTHARAJ
Title or Position: PRESIDENT
Credential: MD
Phone: 440-324-0401