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NPI Code Detail

MEDICARE: UNIVERSITY HOSPITALS MEDICAL GROUP

MEDICARE: UNIVERSITY HOSPITALS MEDICAL GROUP
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
1152W00000XOptometrist
2152WP0200XPediatric Optometrist
3207W00000XOphthalmology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720216237
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY HOSPITALS MEDICAL GROUP
Provider Business Mailing Address
First Line : 24701 EUCLID AVE
Second Line : 3RD FLOOR
City : EUCLID
State : OH
Zip : 44117-1714
Country : US
Telephone Number : 216-383-6616
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line : SUITE 3200
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-3601
Fax Number : 216-844-7117
Authorized Official
Title or Position : VP
Name : LARRY MCELROY
Credential :
Telephone Number : 216-767-8717
Provider Enumeration Date : 06/24/2009
Last Update Date : 11/15/2010

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Directions to “UNIVERSITY HOSPITALS MEDICAL GROUP ” Practice Location

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