Healthcare Provider Details

I. General information

NPI: 1629266747
Provider Name (Legal Business Name): A NORTHCOAST EAR, NOSE AND THROAT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6770 MAYFIELD RD SUITE 322
MAYFIELD HEIGHTS OH
44124-2299
US

IV. Provider business mailing address

6770 MAYFIELD RD SUITE 322
MAYFIELD HEIGHTS OH
44124-2299
US

V. Phone/Fax

Practice location:
  • Phone: 440-449-6798
  • Fax: 440-449-9279
Mailing address:
  • Phone: 440-449-6798
  • Fax: 440-449-9279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SETH SILBERMAN
Title or Position: OWNER
Credential: MD
Phone: 440-449-6798