Healthcare Provider Details

I. General information

NPI: 1205529146
Provider Name (Legal Business Name): NILAS MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 RICHMOND RD STE 102
RICHMOND HEIGHTS OH
44143-2704
US

IV. Provider business mailing address

5456 STONE CREEK DR
SOLON OH
44139-1679
US

V. Phone/Fax

Practice location:
  • Phone: 216-486-3233
  • Fax: 216-486-3180
Mailing address:
  • Phone: 216-486-3233
  • Fax: 216-486-3180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CORATTUR NATESAN
Title or Position: OWNER
Credential: MD
Phone: 216-486-3233