Organization
FAIRVIEW HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY P OLIPHANT (COO)
(216) 939-8835
Entity
Organization
Contact information
Practice address
1730 W 25TH ST, SUITE 1A, CLEVELAND, OH 44113-3108
(216) 363-2120
(216) 696-2856
Mailing address
1730 W 25TH ST, SUITE 1A, CLEVELAND, OH 44113-3108
(216) 363-2120
(216) 696-2856
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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