Basic Information
Provider Information
NPI: 1831376557
EntityType: 2
ReplacementNPI:  
OrganizationName: UNIVERSITY HOSPITALS MEDICAL PRACTICES INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: FEMCARE - DME
OtherOrganizationType: 5
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 74499
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441940002
CountryCode: US
TelephoneNumber: 2163836776
FaxNumber: 2163836745
Practice Location
Address1: 50 BLAINE AVE # 2100
Address2:  
City: BEDFORD
State: OH
PostalCode: 441462709
CountryCode: US
TelephoneNumber: 4407350891
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/24/2008
LastUpdateDate: 01/24/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RIDDLE
AuthorizedOfficialFirstName: STEVE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR OF BILLING SERVICES
AuthorizedOfficialTelephone: 2163836480
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X OHY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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