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NPI Code Detail

MEDICARE: DR. CHRIS L CLEVELAND M.D.

MEDICARE: DR. CHRIS L 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
12080P0201XPediatric Allergy/Immunology Physician12914ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982693875
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRIS L CLEVELAND M.D.
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2400 32ND AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-5800
Country : US
Telephone Number : 701-234-2660
Fax Number : 701-234-8796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 08/29/2022

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