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General NPI Number Information
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NPI Number | 1316775802
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Entity Type | Organization
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Legal Business Name | JEFFREY SHALL MD
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 29001 CEDAR RD
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City | CLEVELAND
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State | OH
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Zip | 44124-4062
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Country | US
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Telephone | 216-973-5807
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Fax |
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Provider Business Mailing Address
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Address Line | 7345 EDWARDS LNDG
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City | CHAGRIN FALLS
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State | OH
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Zip | 44023-1429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JEFFREY SHALL
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Credential | MD
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Telephone | 216-952-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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