MEDICARE: CLEVELAND CARDIOLOGY PLLC

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1841513066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND CARDIOLOGY PLLC

Provider Business Mailing Address
First Line	:	218 NORTH PEARMAN AVENUE
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2634
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 N PEARMAN AVE
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2634
Country	:	US
Telephone Number	:	615-983-4031
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABENDRA NAIDOO
Credential	:	MD
Telephone Number	:	615-983-4031

Provider Enumeration Date	:	03/02/2010
Last Update Date	:	06/30/2010

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