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General NPI Number Information
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NPI Number | 1497955025
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Entity Type | Individual
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Provider Name | HEIDI LYNN ELLIOTT M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/22/2007
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Last Update Date | 11/30/2012
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Provider Practice Location Address
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Address Line | 1110 EUCLID AVE DIVISION OF GENERAL SURGERY
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City | CLEVELAND
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State | OH
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Zip | 44115-1623
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Country | US
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Telephone | 216-286-6888
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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 |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 48716
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 235499
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 14497
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35-099767
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 099767
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License Number State | OH
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