Basic Information
| Provider Information | |||||||||
| NPI: | 1952430191 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY PRIMARY CARE PRACTICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8792 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049158792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408088620 | ||||||||
| FaxNumber: | 4408084372 | ||||||||
| Practice Location | |||||||||
| Address1: | 25651 DETROIT RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441940001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408088620 | ||||||||
| FaxNumber: | 4408084372 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 02/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | MEGERIAN | ||||||||
| AuthorizedOfficialFirstName: | CLIFF | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT OF UH PHYSICIAN SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 2168445500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.