MEDICARE: ROLAND PHILIP 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	208600000X	Surgery Physician	35032101	OH

General Provider Information

NPI Number	:	1811434426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROLAND PHILIP M.D.

Provider Business Mailing Address
First Line	:	2325 DELAMERE DR
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3205
Country	:	US
Telephone Number	:	216-371-5880
Fax Number	:

Provider Business Practice Location Address
First Line	:	2325 DELAMERE DR
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3205
Country	:	US
Telephone Number	:	216-371-5880
Fax Number	:

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

Provider Enumeration Date	:	01/21/2017
Last Update Date	:	01/21/2017

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