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General NPI Number Information
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NPI Number | 1083793715
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Entity Type | Individual
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Provider Name | DIANA WHITTLESEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10701 EAST BLVD 112(W)
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City | CLEVELAND
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State | OH
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Zip | 44106-1702
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Country | US
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Telephone | 216-791-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 21249 SHAKER BLVD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-2631
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Country | US
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Telephone | 216-932-8783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 35-041505
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License Number State | OH
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