Provider Demographics
NPI:1003943697
Name:UNIVERSITY PRIMARY CARE PRACTICES, INC.
Entity Type:Organization
Organization Name:UNIVERSITY PRIMARY CARE PRACTICES, INC.
Other - Org Name:UH CENTER OF ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF UH PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEGERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-844-5500
Mailing Address - Street 1:PO BOX 8792
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-8792
Mailing Address - Country:US
Mailing Address - Phone:440-354-9900
Mailing Address - Fax:440-354-9910
Practice Address - Street 1:6789 RIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129
Practice Address - Country:US
Practice Address - Phone:440-845-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9337198Medicare PIN