Organization
GREAT LAKES PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES SAGHAFI (CHIEF FINANCIAL OFFICER)
(216) 702-0360
Entity
Organization
Contact information
Practice address
6681 RIDGE ROAD, SUITE 300, PARMA, OH 44129-5713
(216) 398-0863
(216) 351-3619
Mailing address
6681 RIDGE ROAD, SUITE 300, PARMA, OH 44129-5713
(216) 398-0863
(216) 351-3619
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2518798
—
OH
Enumeration date
12/28/2005
Last updated
04/30/2008
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