MEDICARE: CLEVELAND EYE SPECIALISTS AND CONSULTANTS, 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	207W00000X	Ophthalmology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CD7175	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1801933734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND EYE SPECIALISTS AND CONSULTANTS, INC.

Provider Business Mailing Address
First Line	:	1611 S GREEN RD
Second Line	:	SUITE 306B
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-4128
Country	:	US
Telephone Number	:	216-291-3550
Fax Number	:	216-291-4849

Provider Business Practice Location Address
First Line	:	6390 PEARL RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44130-3073
Country	:	US
Telephone Number	:	216-291-3550
Fax Number	:	216-291-4849

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID J MITCHELL
Credential	:	M.D.
Telephone Number	:	216-291-3550

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	10/23/2007

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Directions to “CLEVELAND EYE SPECIALISTS AND CONSULTANTS, INC. ” Practice Location

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