Basic Information
| Provider Information | |||||||||
| NPI: | 1144307976 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY EMERGENCY SPECIALISTS OF BEDFORD, INC (GEAUGA) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20010 CENTURY BLVD STE 200 | ||||||||
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| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208741118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2406862300 | ||||||||
| FaxNumber: | 2406862330 | ||||||||
| Practice Location | |||||||||
| Address1: | 13207 RAVENNA RD | ||||||||
| Address2: | |||||||||
| City: | CHARDON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440247032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402856000 | ||||||||
| FaxNumber: | 3306565901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 01/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | HITE | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF REVENUE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2406862300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.