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General NPI Number Information
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NPI Number | 1336435916
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HOSPITALS MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE SUITE 3100
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 24701 EUCLID AVE 3RD FLOOR
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City | EUCLID
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State | OH
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Zip | 44117-1714
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Country | US
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Telephone | 216-383-6616
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Fax |
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Authorized Official
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Title or Position | DIRETOR OF BILLING SERVICES
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Name | STEVE RIDDLE
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Credential |
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Telephone | 216-383-6480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | OH
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