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General NPI Number Information
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NPI Number | 1508181603
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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 | 03/31/2010
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 13207 RAVENNA RD
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City | CHARDON
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State | OH
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Zip | 44024-7032
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Country | US
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Telephone | 216-286-6296
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 WARRENSVILLE CENTER RD SUITE 1342
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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 | 216-286-6341
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Authorized Official
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Title or Position | CONTROLLER
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Name | LARRY MCELROY
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Credential |
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Telephone | 216-383-6756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | OH
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Taxonomy #7
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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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