MEDICARE: CLEVELAND CLINIC

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	261Q00000X	Clinic/Center	047654	OH

General Provider Information

NPI Number	:	1558319491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND CLINIC

Provider Business Mailing Address
First Line	:	99 NORTHLINE CIR
Second Line	:	SUITE 100
City	:	EUCLID
State	:	OH
Zip	:	44119-1482
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 NORTHLINE CIR
Second Line	:	SUITE 100
City	:	EUCLID
State	:	OH
Zip	:	44119-1482
Country	:	US
Telephone Number	:	216-692-7771
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DANIEL MEDVE
Credential	:
Telephone Number	:	216-973-3321

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	01/06/2022

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Directions to “CLEVELAND CLINIC ” Practice Location

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