Organization
LAKE HEALTH-UNIVERSITY HOSPITALS SEIDMAN CANCER CTR PHYSICIANS INC
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 STE 3, MENTOR, OH 44060-8711
(440) 205-5775
(440) 205-5733
Mailing address
9485 MENTOR AVE STE 3, MENTOR, OH 44060-8711
(440) 205-5755
(440) 205-5743
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144250
PK
—
05
—
2560590
—
OH
Enumeration date
05/19/2006
Last updated
07/03/2014
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