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NPI Code Detail

MEDICARE: DR. DENISE DEBRA DEWALD M.D.

MEDICARE: DR. DENISE DEBRA DEWALD 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
1207R00000XInternal Medicine Physician036.129610IL
2208000000XPediatrics Physician036.129610IL
32080S0012XPediatric Sleep Medicine Physician35.143654OH
4390200000XStudent in an Organized Health Care Education/Training Program57.246006OH
5207RS0012XSleep Medicine (Internal Medicine) Physician35.143654OH

General Provider Information

NPI Number : 1760669436
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENISE DEBRA DEWALD M.D.
Provider Business Mailing Address
First Line : 2500 METROHEALTH DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1900
Country : US
Telephone Number : 216-844-1000
Fax Number :
Provider Business Practice Location Address
First Line : 2500 METROHEALTH DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1900
Country : US
Telephone Number : 216-778-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2008
Last Update Date : 11/03/2023

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