Organization
MAPLE MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHUSUDAN T SHETH M.D., C.M.D. (PRESIDENT)
(216) 662-3040
Entity
Organization
Contact information
Practice address
16173 LIBBY RD, MAPLE HEIGHTS, OH 44137-1245
(216) 662-3040
Mailing address
16173 LIBBY RD, MAPLE HEIGHTS, OH 44137-1245
(216) 662-3040
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35038621
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2752490
—
OH
Enumeration date
04/21/2007
Last updated
10/17/2008
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