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General NPI Number Information
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NPI Number | 1033342662
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HOSPITAL MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 2181 AMBLESIDE ROAD
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-721-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 WARRENSVILLE CENTER RD 1ST FLOOR
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City | SHAKER HTS
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State | OH
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Zip | 44122-5203
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Country | US
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Telephone | 216-286-6260
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Fax | 216-286-6341
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Authorized Official
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Title or Position | SUPERVISOR
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Name | JOI WILLIAMS
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Credential |
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Telephone | 440-214-8025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State | OH
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