Individual
MARY ELLEN LAWLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 METROHEALTH DR # 4, CLEVELAND, OH 44109-1900
(216) 778-1304
Mailing address
2500 METROHEALTH DR, CLEVELAND, OH 44109-1900
(216) 778-1304
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
166405
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
NONE
—
Enumeration date
05/10/2019
Last updated
05/10/2019
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