Basic Information
| Provider Information | |||||||||
| NPI: | 1144246539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ULI | ||||||||
| FirstName: | NAVEEN | ||||||||
| MiddleName: | KUMAR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24701 EUCLID AVE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | EUCLID | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441171714 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441061716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168447700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 08/18/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0205X | 35-081292 | OH | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology |
ID Information
| ID | Type | State | Issuer | Description | 000000221422 | 01 | OH | UNISON | OTHER | 000000229957 | 01 | OH | ANTHEM | OTHER | 738681 | 01 | OH | BUCKEYE | OTHER | 2335477 | 01 | OH | BCMH | OTHER | 364090 | 01 | OH | WELLCARE | OTHER | 7469211 | 01 | OH | AETNA | OTHER | 2335477 | 05 | OH | MEDICAID | 000000526164 | 01 | OH | ANTHEM | OTHER | 001919820001 | 05 | PA | MEDICAID |