MEDICARE: UNIVERSITY PRIMARY CARE PRACTICES, INC.

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1124155999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY PRIMARY CARE PRACTICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 8792
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-8792
Country	:	US
Telephone Number	:	440-406-5800
Fax Number	:	216-201-6914

Provider Business Practice Location Address
First Line	:	6150 EMERALD ST
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-2048
Country	:	US
Telephone Number	:	440-406-5800
Fax Number	:	216-201-6914

Authorized Official
Title or Position	:	PRESIDENT OF UH PHYSICIAN SERVICES
Name	:	DR. CLIFF A MEGERIAN
Credential	:	MD
Telephone Number	:	216-844-5500

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	04/01/2019

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