Basic Information
| Provider Information | |||||||||
| NPI: | 1366903643 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ATRIUM INPATIENT MEDICAL SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 395 E SAINT ANDREWS DR | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND HTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441433660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4404882300 | ||||||||
| FaxNumber: | 4405964860 | ||||||||
| Practice Location | |||||||||
| Address1: | 395 E SAINT ANDREWS DR | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND HTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441433660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4404491540 | ||||||||
| FaxNumber: | 4404602833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2019 | ||||||||
| LastUpdateDate: | 06/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | MUKUNDA | ||||||||
| AuthorizedOfficialFirstName: | BEEJADI | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | TAX ID OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4404491540 | ||||||||
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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 | 207R00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.