MEDICARE: MOUNT CARMEL HEALTH PROVIDERS 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1710153838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT CARMEL HEALTH PROVIDERS INC

Provider Business Mailing Address
First Line	:	PO BOX 951603
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0018
Country	:	US
Telephone Number	:	614-546-4400
Fax Number	:	614-546-4441

Provider Business Practice Location Address
First Line	:	2150 MARBLE CLIFF OFFICE PARK
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-1056
Country	:	US
Telephone Number	:	614-299-6333
Fax Number	:	614-299-6054

Authorized Official
Title or Position	:	COO
Name	:	PAUL C SCHUTTE
Credential	:
Telephone Number	:	614-546-4424

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	06/02/2010

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