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NPI Code Detail

MEDICARE: GASTROINTESTINAL ASSOCIATES OF CLEVELAND, PC

MEDICARE: GASTROINTESTINAL ASSOCIATES OF CLEVELAND, PC
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
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1316981087
Entity Type Code : Organization
Provider Name (Legal Business Name) : GASTROINTESTINAL ASSOCIATES OF CLEVELAND, PC
Provider Business Mailing Address
First Line : 2415 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3882
Country : US
Telephone Number : 423-559-2800
Fax Number : 423-559-0532
Provider Business Practice Location Address
First Line : 2415 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3882
Country : US
Telephone Number : 423-559-2800
Fax Number : 423-559-0532
Authorized Official
Title or Position : PRACTICE MANAGER
Name : KAREN M. BOWMAN
Credential : FACMPE, CPC, CPMA
Telephone Number : 423-559-2800
Provider Enumeration Date : 06/15/2006
Last Update Date : 10/07/2020

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