MEDICARE: BEWELL SOLUTIONS

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

General Provider Information

NPI Number	:	1134437577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEWELL SOLUTIONS

Provider Business Mailing Address
First Line	:	3681 GREEN RD
Second Line	:	SUITE 410
City	:	CLEVELAND
State	:	OH
Zip	:	44122-5726
Country	:	US
Telephone Number	:	216-378-0888
Fax Number	:	216-360-9712

Provider Business Practice Location Address
First Line	:	3681 GREEN RD
Second Line	:	SUITE 410
City	:	CLEVELAND
State	:	OH
Zip	:	44122-5726
Country	:	US
Telephone Number	:	216-378-0888
Fax Number	:	216-360-9712

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RONALD GOLOVAN
Credential	:	M.D.
Telephone Number	:	216-696-2205

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	09/20/2010

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Directions to “BEWELL SOLUTIONS ” Practice Location

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