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General NPI Number Information
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NPI Number | 1346366671
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Entity Type | Organization
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Legal Business Name | SERWAH MEDICAL GROUP, INC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 1831 FOREST HILLS BLVD #102
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City | E CLEVELAND
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State | OH
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Zip | 44112-4348
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Country | US
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Telephone | 216-541-3600
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Fax | 216-541-5528
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Provider Business Mailing Address
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Address Line | 4758 RIDGE RD #161
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City | CLEVELAND
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State | OH
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Zip | 44144-3327
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Country | US
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Telephone | 440-235-8484
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Fax | 440-235-8440
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Authorized Official
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Title or Position | EMPLOYEE
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Name | TEAH ABASHIDZE
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Credential | MD
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Telephone | 216-541-3600
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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 | 35083950-A
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License Number State | OH
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