Basic Information
| Provider Information | |||||||||
| NPI: | 1184801037 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY HOSPITALS MEDICAL PRACTICES INC | ||||||||
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| OtherOrganizationName: | UNIVERSITY COMMUNITY ORTHOPEDICS - DME | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 74751 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441940834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163836776 | ||||||||
| FaxNumber: | 2163836745 | ||||||||
| Practice Location | |||||||||
| Address1: | 15976 EAST HIGH STREET | ||||||||
| Address2: | ORTHO SUITE | ||||||||
| City: | MIDDLEFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406320408 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2008 | ||||||||
| LastUpdateDate: | 01/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | RIDDLE | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BILING SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 2163836480 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.