MEDICARE: JAMES G EPSTEIN MD 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	207R00000X	Internal Medicine Physician	35049225E	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DG3910	OTHER	OH	RAILROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	36D1000944	OTHER	OH	CLIA

General Provider Information

NPI Number	:	1396846358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES G EPSTEIN MD INC

Provider Business Mailing Address
First Line	:	PO BOX 241217
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-8817
Country	:	US
Telephone Number	:	440-239-8737
Fax Number	:	440-239-7811

Provider Business Practice Location Address
First Line	:	18660 BAGLEY RD
Second Line	:	STE 400B
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-8455
Country	:	US
Telephone Number	:	440-239-8737
Fax Number	:	440-239-7811

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MS. RENEE J. EPSTEIN
Credential	:
Telephone Number	:	440-239-8737

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/07/2021

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