=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033377759
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RUCHI YADAV MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2008
-----------------------------------------------------
Last Update Date | 01/02/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9500 EUCLID AVENUE CLEVELAND CLINIC
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-444-5690
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9500 EUCLID AVENUE NA-23 GRADUATE MEDICAL EDUCATION NA-23
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-444-5690
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | 35.095636
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------