Basic Information
Provider Information
NPI: 1932383932
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERMEL
FirstName: ROBERT
MiddleName: ANTHONY
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9500 EUCLID AVE
Address2: BUILDING U10
City: CLEVELAND
State: OH
PostalCode: 441950001
CountryCode: US
TelephoneNumber: 2164448600
FaxNumber: 2164456259
Practice Location
Address1: 9500 EUCLID AVE
Address2: BUILDING U10
City: CLEVELAND
State: OH
PostalCode: 441950001
CountryCode: US
TelephoneNumber: 2164448600
FaxNumber: 2164456259
Other Information
ProviderEnumerationDate: 12/27/2007
LastUpdateDate: 12/27/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X090927OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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