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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1235255316
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	:	440-974-4211
Fax Number	:	440-974-4273

Provider Business Practice Location Address
First Line	:	18599 LAKE SHORE BLVD
Second Line	:	STE 500
City	:	EUCLID
State	:	OH
Zip	:	44119-1093
Country	:	US
Telephone Number	:	216-383-7850
Fax Number	:	216-383-7988

Authorized Official
Title or Position	:	UHPS PRESIDENT
Name	:	CLIFF MEGARIAN
Credential	:
Telephone Number	:	216-844-5500

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	02/06/2017

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