Organization
LAKE HEALTH-UNIVERSITY HOSPITALS SEIDMAN CANCER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE MORAN (EXECUTIVE DIRECTOR)
(440) 205-5759
Entity
Organization
Contact information
Practice address
9485 MENTOR AVE, SUITE 3, MENTOR, OH 44060-4597
(440) 205-5759
(440) 205-5790
Mailing address
9485 MENTOR AVE, SUITE 3, MENTOR, OH 44060-4597
(440) 205-5759
(440) 205-5790
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2103315
—
OH
Enumeration date
11/03/2006
Last updated
11/11/2013
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