Basic Information
| Provider Information | |||||||||
| NPI: | 1255430864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VATEV | ||||||||
| FirstName: | VIRGINIA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 901543 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441901543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402502070 | ||||||||
| FaxNumber: | 4402502071 | ||||||||
| Practice Location | |||||||||
| Address1: | 960 CLAGUE RD STE 3201 | ||||||||
| Address2: | |||||||||
| City: | WESTLAKE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441451588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163830100 | ||||||||
| FaxNumber: | 2163836481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 11/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35061518 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 35061518V | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.