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General NPI Number Information
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NPI Number | 1154376457
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Entity Type | Organization
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Legal Business Name | FAIRVIEW GENERAL HOSPITAL
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 850 COLUMBIA RD
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City | WESTLAKE
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State | OH
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Zip | 44145-1493
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Country | US
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Telephone | 440-835-8527
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Fax |
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Provider Business Mailing Address
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Address Line | 20525 CENTER RIDGE RD SUITE 220
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City | ROCKY RIVER
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State | OH
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Zip | 44116-3437
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Country | US
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Telephone | 440-895-5021
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Fax | 440-895-5050
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MARK E WIEDT
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Credential |
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Telephone | 440-895-5021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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