MEDICARE: MICHAEL NEIL HUBER M.D.

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
1	207R00000X	Internal Medicine Physician	35071679	OH
2	208M00000X	Hospitalist Physician	35071679	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	341926264034	OTHER	OH	CARESOURSE
2	000000141919	OTHER	OH	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114954393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL NEIL HUBER M.D.

Provider Business Mailing Address
First Line	:	6090 ROYALTON RD
Second Line	:	SUITE 335
City	:	CLEVELAND
State	:	OH
Zip	:	44133-5104
Country	:	US
Telephone Number	:	330-237-8000
Fax Number	:	877-921-2530

Provider Business Practice Location Address
First Line	:	6090 ROYALTON RD
Second Line	:	SUITE 335
City	:	CLEVELAND
State	:	OH
Zip	:	44133-5104
Country	:	US
Telephone Number	:	330-237-8000
Fax Number	:	877-921-2530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	04/14/2015

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