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NPI Code Detail

MEDICARE: FRED STANLEY HIRSH M.D.

MEDICARE:   FRED STANLEY HIRSH  M.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
1207N00000XDermatology Physician35034894OH

General Provider Information

NPI Number : 1700992716
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRED STANLEY HIRSH M.D.
Provider Business Mailing Address
First Line : 6551 WILSON MILLS RD
Second Line : SUITE 101
City : CLEVELAND
State : OH
Zip : 44143-3495
Country : US
Telephone Number : 440-460-2884
Fax Number : 440-460-2885
Provider Business Practice Location Address
First Line : 6551 WILSON MILLS RD
Second Line : SUITE 101
City : CLEVELAND
State : OH
Zip : 44143-3495
Country : US
Telephone Number : 440-460-2884
Fax Number : 440-460-2885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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Directions to “ FRED STANLEY HIRSH M.D.” Practice Location

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