Organization
NORTHEAST OHIO GROUP PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD PEW (VICE-PRESIDENT)
(307) 262-9410
Entity
Organization
Contact information
Practice address
2351 E 22ND ST, CLEVELAND, OH 44115-3111
(216) 861-6200
Mailing address
30680 BAINBRIDGE RD, SOLON, OH 44139-2282
(440) 542-5023
(440) 542-5029
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2270019
—
OH
Enumeration date
06/25/2006
Last updated
01/07/2025
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