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NPI Code Detail

MEDICARE: JONATHAN DALE UMBEL D.O

MEDICARE: JONATHAN DALE UMBEL D.O
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
1207RG0100XGastroenterology Physician34.010844OH

General Provider Information

NPI Number : 1831485028
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN DALE UMBEL D.O
Provider Business Mailing Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-1000
Fax Number :
Provider Business Practice Location Address
First Line : 29000 CENTER RIDGE RD
Second Line : SUITE 150
City : WESTLAKE
State : OH
Zip : 44145-5293
Country : US
Telephone Number : 440-827-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2011
Last Update Date : 02/02/2016

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