# LAKE HEALTH-UNIVERSITY HOSPITALS SEIDMAN CANCER CTR PHYSICIANS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356394357
- **Authorized official:** JULIE MORAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (440) 205-5759

## Contact information

- **Practice address:** 9485 MENTOR AVE STE 3, MENTOR, OH 44060-8711
- **Practice address phone:** (440) 205-5775
- **Practice address fax:** (440) 205-5733
- **Mailing address:** 9485 MENTOR AVE STE 3, MENTOR, OH 44060-8711
- **Mailing address phone:** (440) 205-5755
- **Mailing address fax:** (440) 205-5743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 07/03/2014