Basic Information
| Provider Information | |||||||||
| NPI: | 1780874206 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY HOSPITALS HEALTH SYSTEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2833 VAN AKEN BLVD APT 4 | ||||||||
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| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441202255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407961534 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE, | ||||||||
| Address2: | LKS 5029 | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168441000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2007 | ||||||||
| LastUpdateDate: | 07/31/2007 | ||||||||
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| AuthorizedOfficialLastName: | KEITH | ||||||||
| AuthorizedOfficialFirstName: | ARMITAGE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2168441000 | ||||||||
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| 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 | 282N00000X | 57.012660 | OH | Y | Hospitals | General Acute Care Hospital |
No ID Information.