Basic Information
| Provider Information | |||||||||
| NPI: | 1184830986 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY HOSPITALS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1188 E 340TH ST | ||||||||
| Address2: | |||||||||
| City: | EASTLAKE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440952935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409421675 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441061716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168441000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PATEL | ||||||||
| AuthorizedOfficialFirstName: | PRAGNA | ||||||||
| AuthorizedOfficialMiddleName: | BHARAT | ||||||||
| AuthorizedOfficialTitleorPosition: | PGY 2 | ||||||||
| AuthorizedOfficialTelephone: | 2168441000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NW0100X | 57.010065 | OH | Y | Hospitals | General Acute Care Hospital | Women |
No ID Information.