Basic Information
Provider Information
NPI: 1306263314
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOOLITTLE
FirstName: ROSE
MiddleName: MCCOY
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2500 METROHEALTH DR
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441091900
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2500 METROHEALTH DR
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441091900
CountryCode: US
TelephoneNumber: 3122274000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2014
LastUpdateDate: 06/15/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/15/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080N0001X35.139833OHN Allopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
208000000X6663320WIY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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