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General NPI Number Information
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NPI Number | 1396746921
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Entity Type | Organization
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Legal Business Name | CLEVELAND EAR NOSE THROAT AND ALLERGY CENTER INC
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5400 TRANSPORTATION BLVD SUITE 8
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125-5324
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Country | US
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Telephone | 216-662-3711
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Fax | 216-662-5139
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Provider Business Mailing Address
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Address Line | P.O. BOX 72591
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City | CLEVELAND
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State | OH
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Zip | 44192
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Country | US
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Telephone | 216-662-3711
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Fax | 216-662-5139
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Authorized Official
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Title or Position | PRESIDENT, CLEVELAND EAR NOSE THROA
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Name | BERT BROWN
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Credential | M.D.
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Telephone | 216-662-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | OH
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