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General NPI Number Information
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NPI Number | 1780785683
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Entity Type | Organization
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Legal Business Name | UNIVERSITY-GEAUGA FAMILY PHYSICIANS, INC.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 12714 OPALOCKA DR
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City | CHESTERLAND
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State | OH
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Zip | 44026-2642
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Country | US
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Telephone | 440-729-3745
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Fax | 440-729-2647
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Provider Business Mailing Address
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Address Line | 12714 OPALOCKA DR
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City | CHESTERLAND
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State | OH
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Zip | 44026-2642
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Country | US
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Telephone | 440-729-3745
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Fax | 440-729-2647
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. THOMAS MUTHER METTEE
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Credential | M.D.
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Telephone | 440-729-3745
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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 | 35042570
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License Number State | OH
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