Organization
CLEVELAND CENTER FOR JOINT RECONSTRUCTION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD STULBERG MD (AUTHORIZED REPRESENTATIVE)
(216) 363-2096
Entity
Organization
Contact information
Practice address
1730 W 25TH ST, CLEVELAND, OH 44113-3108
(216) 363-2096
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0870884
—
OH
01
—
105758
KAISER PERMANENTE
OH
01
—
128086800
DEPARTMENT OF LABOR
OH
Enumeration date
11/26/2007
Last updated
05/21/2008
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