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Organization

CLEVELAND COMMUNITY PHYSICIANS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK MCLONEY M.D. (PRESIDENT)
(440) 816-1120
Entity
Organization

Contact information

Practice address
398 W BAGLEY RD, SUITE 1, BEREA, OH 44017-1369
(440) 816-1120
(440) 816-1022
Mailing address
PO BOX 771103, LAKEWOOD, OH 44107-0047
(216) 472-2730
(216) 472-2740

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RP1001X
Pulmonary Disease Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3088699
OH
Enumeration date
04/30/2010
Last updated
02/15/2013
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