Healthcare Provider Details

I. General information

NPI: 1659369452
Provider Name (Legal Business Name): PHYSICIANS FOR PULMONARY & CRITICAL CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 SOM CENTER RD #25
MAYFIELD HTS OH
44124-2118
US

IV. Provider business mailing address

1450 SOM CENTER RD #25
MAYFIELD HTS OH
44124-2118
US

V. Phone/Fax

Practice location:
  • Phone: 440-446-1423
  • Fax: 440-446-1498
Mailing address:
  • Phone: 440-446-1423
  • Fax: 440-446-1498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC JAMES DINGA
Title or Position: PRESIDENT
Credential: MD
Phone: 440-446-1423