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General NPI Number Information
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NPI Number | 1659364891
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Entity Type | Individual
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Provider Name | JEREMY C HOBAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-5293
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Country | US
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Telephone | 216-844-7330
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 WARRENSVILLE CENTER ROAD 1ST FLOOR
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City | SHAKER HTS
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State | OH
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Zip | 44122
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Country | US
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Telephone | 440-891-8800
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Fax | 440-891-1734
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 35-082812
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35-082812
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License Number State | OH
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