MEDICARE: DR. CYNTHIA CLEVELAND 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	174400000X	Specialist	31755	MN

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	:	1912908112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA CLEVELAND M.D.

Provider Business Mailing Address
First Line	:	300 1ST AVE NW
Second Line	:	SUITE 230
City	:	ROCHESTER
State	:	MN
Zip	:	55901-2830
Country	:	US
Telephone Number	:	507-361-1231
Fax Number	:	507-361-1241

Provider Business Practice Location Address
First Line	:	300 1ST AVE NW
Second Line	:	SUITE 230
City	:	ROCHESTER
State	:	MN
Zip	:	55901-2830
Country	:	US
Telephone Number	:	507-361-1231
Fax Number	:	507-361-1241

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/05/2012

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