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General NPI Number Information
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NPI Number | 1427239383
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Entity Type | Organization
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Legal Business Name | NORTH COAST INSTITUTE OF DIABETES AND ENDOCRINOLOGY, INC.
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 25101 DETROIT RD SUITE 440
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City | WESTLAKE
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State | OH
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Zip | 44145-2552
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Country | US
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Telephone | 440-892-1070
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Fax | 440-892-1242
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Provider Business Mailing Address
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Address Line | 25101 DETROIT RD SUITE 440
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City | WESTLAKE
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State | OH
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Zip | 44145-2552
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Country | US
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Telephone | 440-892-1070
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Fax | 440-892-1242
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Authorized Official
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Title or Position | PRESIDENT AND MEDICAL DIRECTOR
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Name | DR. JOHN PATRICK SHEEHAN
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Credential | MD
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Telephone | 440-892-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 49609
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License Number State | OH
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