Organization
FAIRVIEW HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD P OLIPHANT (COO)
(216) 476-7000
Entity
Organization
Contact information
Practice address
21851 CENTER RIDGE RD, ROCKY RIVER, OH 44116-3976
(440) 333-3332
(216) 696-7296
Mailing address
1730 W 25TH ST, #122, CLEVELAND, OH 44113-3108
(216) 363-2475
(216) 696-7296
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
12/16/2006
Last updated
08/22/2020
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