MEDICARE: UNIVERSITY HOSPITALS MEDICAL PRACTICES INC

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	208000000X	Pediatrics Physician		OH

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	:	1982873683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY HOSPITALS MEDICAL PRACTICES INC

Provider Business Mailing Address
First Line	:	PO BOX 74568
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44194-0002
Country	:	US
Telephone Number	:	216-383-6776
Fax Number	:	216-383-6745

Provider Business Practice Location Address
First Line	:	18599 LAKE SHORE BLVD STE 100
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44119-1099
Country	:	US
Telephone Number	:	216-383-7800
Fax Number	:	216-383-5376

Authorized Official
Title or Position	:	DIRECTOR OF BILLING SERVICES
Name	:	STEVE RIDDLE
Credential	:
Telephone Number	:	216-383-6480

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	02/27/2008

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Directions to “UNIVERSITY HOSPITALS MEDICAL PRACTICES INC ” Practice Location

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