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General NPI Number Information
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NPI Number | 1093049900
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Entity Type | Organization
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Legal Business Name | CLEVELAND CLINIC
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 09/24/2009
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE P21, DEPARTMENT OF PEDIATRIC ANESTHESIOLOGY
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City | CLEVELAND
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State | OH
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Zip | 44195
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Country | US
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Telephone | 216-444-5996
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVE P21, DEPARTMENT OF PEDIATRIC ANESTHESIOLOGY
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-5996
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN, PEDIATRIC ANESTHESIA
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Name | STEPHEN KIMATIAN
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Credential | M.D.
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Telephone | 216-444-5996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 35091798
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License Number State | OH
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