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General NPI Number Information
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NPI Number | 1588629174
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Entity Type | Individual
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Provider Name | TOD R PODL MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 1000 EATON BLVD
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City | BEACHWOOD
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State | OH
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Zip | 44122-6058
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Country | US
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Telephone | 440-523-3100
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Fax | 440-523-3101
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Provider Business Mailing Address
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Address Line | 1000 EATON BLVD
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City | BEACHWOOD
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State | OH
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Zip | 44122-6058
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Country | US
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Telephone | 440-523-3100
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Fax | 440-523-3101
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35073244P
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License Number State | OH
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