MEDICARE: JAMES M MEDLING 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
1	103TC0700X	Clinical Psychologist	3081	OH

General Provider Information

NPI Number	:	1598821696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M MEDLING PH.D.

Provider Business Mailing Address
First Line	:	7057 W 130TH ST STE 201
Second Line	:
City	:	PARMA HEIGHTS
State	:	OH
Zip	:	44130-7841
Country	:	US
Telephone Number	:	440-842-2222
Fax Number	:	440-842-5547

Provider Business Practice Location Address
First Line	:	7057 W 130TH ST STE 201
Second Line	:
City	:	PARMA HEIGHTS
State	:	OH
Zip	:	44130-7841
Country	:	US
Telephone Number	:	440-842-2222
Fax Number	:	440-842-5547

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2006
Last Update Date	:	05/23/2008

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