Healthcare Provider Details
I. General information
NPI: 1730273640
Provider Name (Legal Business Name): NORTHCOAST HAND CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26908 DETROIT RD SUITE 200
WESTLAKE OH
44145-2398
US
IV. Provider business mailing address
26908 DETROIT RD SUITE 200
WESTLAKE OH
44145-2398
US
V. Phone/Fax
- Phone: 440-871-6060
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
B
EVANS
JR.
Title or Position: OWNER
Credential: MD
Phone: 440-871-6060