Basic Information
| Provider Information | |||||||||
| NPI: | 1003295106 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNIVERSITY HOSPITAL RICHMOND MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27100 CHARDON RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441431116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405168704 | ||||||||
| FaxNumber: | 4405856141 | ||||||||
| Practice Location | |||||||||
| Address1: | 27100 CHARDON RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441431116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405168704 | ||||||||
| FaxNumber: | 4405856141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2015 | ||||||||
| LastUpdateDate: | 05/21/2015 | ||||||||
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| AuthorizedOfficialLastName: | SAAR | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | RESIDENCY DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4409440200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNIVERSITY HOSPITALS HEALTH SYSTEM | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DPM | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | OH | Y | Hospitals | General Acute Care Hospital |
No ID Information.