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General NPI Number Information
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NPI Number | 1205903093
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Entity Type | Individual
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Provider Name | ELIZABETH P MACINTYRE M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2322 E 22ND ST SUITE 306
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City | CLEVELAND
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State | OH
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Zip | 44115-3176
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Country | US
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Telephone | 216-566-0463
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Fax |
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Provider Business Mailing Address
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Address Line | 2719 WICKLOW RD
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City | SHAKER HTS
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State | OH
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Zip | 44120-1335
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Country | US
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Telephone | 216-321-8441
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35-044660
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License Number State | OH
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