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General NPI Number Information
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NPI Number | 1104201839
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PRIMARY CARE PRACTICES, INC.
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 1120 E BROAD ST STE 200
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City | ELYRIA
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State | OH
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Zip | 44035-6306
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Country | US
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Telephone | 440-326-4410
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Fax | 216-201-6913
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Provider Business Mailing Address
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Address Line | PO BOX 8792
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City | BELFAST
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State | ME
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Zip | 04915-8792
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Country | US
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Telephone | 440-326-4410
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Fax | 216-201-6913
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Authorized Official
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Title or Position | PRESIDENT OF UH PHYSICIAN SERVICES
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Name | DR. CLIFF A MEGERIAN
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Credential | MD
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Telephone | 216-844-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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