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NPI Code Detail

MEDICARE: GRACE STATDFIELD PA-C

MEDICARE: GRACE STATDFIELD PA-C
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
1363A00000XPhysician Assistant50.009717RXOH
22084E0001XEpilepsy Physician50.009717RXOH

General Provider Information

NPI Number : 1982440715
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE STATDFIELD PA-C
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0002
Country : US
Telephone Number : 216-444-2200
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0002
Country : US
Telephone Number : 216-444-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2024
Last Update Date : 03/10/2026

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Directions to “ GRACE STATDFIELD PA-C” Practice Location

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