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General NPI Number Information
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NPI Number | 1497072185
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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 | 04/21/2010
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 5778 DARROW RD SUITE 103
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City | HUDSON
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State | OH
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Zip | 44236-3808
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Country | US
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Telephone | 555-555-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 WARRENSVILLE CENTER RD 1ST FLOOR
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-5203
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Country | US
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Telephone | 216-286-6296
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Fax |
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Authorized Official
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Title or Position | SUPV
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Name | JOI WILLIAMS
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Credential |
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Telephone | 440-214-8025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | OH
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