MEDICARE: EVA HU-WHITTEMORE 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
1	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	35057304	OH

General Provider Information

NPI Number	:	1710983820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA HU-WHITTEMORE M.D.

Provider Business Mailing Address
First Line	:	1280 SOM CENTER RD
Second Line	:	UNIT 234
City	:	CLEVELAND
State	:	OH
Zip	:	44124-2048
Country	:	US
Telephone Number	:	330-758-4515
Fax Number	:	330-758-5121

Provider Business Practice Location Address
First Line	:	1280 SOM CENTER RD
Second Line	:	UNIT 234
City	:	CLEVELAND
State	:	OH
Zip	:	44124-2048
Country	:	US
Telephone Number	:	330-758-4515
Fax Number	:	330-758-5121

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/08/2007

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