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General NPI Number Information
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NPI Number | 1043845548
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD HEALTH AND WEIGHT MEDICAL, LLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 27014 CENTER RIDGE RD
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City | WESTLAKE
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State | OH
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Zip | 44145-4045
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Country | US
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Telephone | 810-513-8063
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 770577
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City | LAKEWOOD
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State | OH
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Zip | 44107-0029
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Country | US
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Telephone | 810-513-8063
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA LOURDES TRONCALES MALICDEM
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Credential | MD
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Telephone | 810-513-8063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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