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General NPI Number Information
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NPI Number | 1598928137
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Entity Type | Organization
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Legal Business Name | DIABETES AND ENDOCRINE CENTER OF CLEVELAND INC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 12000 MCCRACKEN RD STE 111
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125-2933
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Country | US
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Telephone | 216-587-8980
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Fax | 216-504-0005
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Provider Business Mailing Address
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Address Line | 3733 PARK EAST DR STE 105
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City | BEACHWOOD
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State | OH
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Zip | 44122-4337
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Country | US
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Telephone | 216-504-0001
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Fax | 216-504-0005
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Authorized Official
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Title or Position | DOCTOR
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Name | DANIEL B MENDLOVIC
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Credential |
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Telephone | 216-587-8980
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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 | 35056791
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License Number State | OH
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