Provider Demographics
NPI:1104367820
Name:UNIVERSITY PRIMARY CARE PRACTICES, INC.
Entity Type:Organization
Organization Name:UNIVERSITY PRIMARY CARE PRACTICES, INC.
Other - Org Name:CENTER FOR OTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:UHPS PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGARIAN
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:440-329-2800
Mailing Address - Fax:440-329-2810
Practice Address - Street 1:224 W LORAIN ST
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1096
Practice Address - Country:US
Practice Address - Phone:440-329-2800
Practice Address - Fax:440-329-2810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-06-30
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
OH4252080042OtherMEDICARE NSC