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NPI Code Detail

MEDICARE: ROBERT TAYLOR SEGRAVES MD, PH.D

MEDICARE: ROBERT TAYLOR SEGRAVES MD, PH.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
12084P0805XGeriatric Psychiatry Physician35053947OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215963087
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT TAYLOR SEGRAVES MD, PH.D
Provider Business Mailing Address
First Line : 23230 CHAGRIN BLVD
Second Line : SUITE 350
City : BEACHWOOD
State : OH
Zip : 44122-5446
Country : US
Telephone Number : 216-831-2900
Fax Number :
Provider Business Practice Location Address
First Line : 23230 CHAGRIN BLVD
Second Line : SUITE 350
City : BEACHWOOD
State : OH
Zip : 44122-5446
Country : US
Telephone Number : 216-831-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2006
Last Update Date : 04/20/2011

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