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NPI Code Detail

MEDICARE: ROBERT FERGUSON

MEDICARE:   ROBERT  FERGUSON
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1114619731
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT FERGUSON
Provider Business Mailing Address
First Line : 3639 MOUNT LAUREL RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44121-1328
Country : US
Telephone Number : 216-386-1110
Fax Number :
Provider Business Practice Location Address
First Line : 3639 MOUNT LAUREL RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44121-1328
Country : US
Telephone Number : 216-386-1110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2023
Last Update Date : 05/23/2023

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Directions to “ ROBERT FERGUSON ” Practice Location

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