Organization
CDC PHYSICIANS ORGANIZATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLE A NEMECEK (COO)
(216) 658-0458
Entity
Organization
Contact information
Practice address
18720 CHAGRIN BLVD, SHAKER HEIGHTS, OH 44122-4855
(216) 295-7003
(216) 295-7014
Mailing address
18720 CHAGRIN BLVD, SHAKER HEIGHTS, OH 44122-4855
(216) 295-7003
(216) 295-7014
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
35081307
OH
2085R0204X
Vascular & Interventional Radiology Physician
35062206
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2329126
—
OH
Enumeration date
11/06/2006
Last updated
03/03/2025
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