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General NPI Number Information
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NPI Number | 1861174393
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASE SPECIALTIES INC
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 7255 OLD OAK BLVD BLDG C STE 302
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City | CLEVELAND
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State | OH
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Zip | 44130-3329
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Country | US
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Telephone | 216-402-8713
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Fax | 440-816-6755
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Provider Business Mailing Address
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Address Line | 30701 LORAIN RD STE A
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-6325
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Country | US
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Telephone | 440-274-5035
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BELAI DAMTEW
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Credential |
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Telephone | 216-402-8713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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