Organization
UNIVERSITY HOSPITALS MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MCELROY (CONTROLLER)
(216) 383-6756
Entity
Organization
Contact information
Practice address
18599 LAKE SHORE BLVD, SUITE 111, EUCLID, OH 44119-1093
(216) 286-6296
(216) 286-6341
Mailing address
3605 WARRENSVILLE CENTER RD, OFFICE 1342, SHAKER HEIGHTS, OH 44122-5203
(216) 286-6296
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
OH
2085R0202X
Diagnostic Radiology Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2691903
—
OH
Enumeration date
03/24/2010
Last updated
03/24/2010
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