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Organization

EASTSIDE ENT SPECIALISTS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. E. LUKE BOLD M.D. (VICE PRESIDENT)
(440) 352-1474
Entity
Organization

Contact information

Practice address
7580 AUBURN ROAD, #103, PAINESVILLE, OH 44077
(440) 352-1474
(440) 352-2662
Mailing address
7580 AUBURN ROAD, #103, PAINESVILLE, OH 44077
(440) 352-1474
(440) 352-2662

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0666364
OH
Enumeration date
01/25/2006
Last updated
02/16/2010
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