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NPI Code Detail

MEDICARE: DR. ELEANOR WARNOCK DAVIDSON MD

MEDICARE: DR. ELEANOR WARNOCK DAVIDSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35-052336OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
235-052336OTHEROHSTATE MEDICAL BOARD LICEN

General Provider Information

NPI Number : 1023131125
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELEANOR WARNOCK DAVIDSON MD
Provider Business Mailing Address
First Line : 10900 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-4901
Country : US
Telephone Number : 216-368-6150
Fax Number : 216-368-8530
Provider Business Practice Location Address
First Line : 10900 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-4901
Country : US
Telephone Number : 216-368-6150
Fax Number : 216-368-8530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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