Provider Demographics
NPI:1114095775
Name:FRED S HIRSH MD INC
Entity Type:Organization
Organization Name:FRED S HIRSH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:HIRSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-460-2884
Mailing Address - Street 1:6551 WILSON MILLS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3495
Mailing Address - Country:US
Mailing Address - Phone:440-460-2884
Mailing Address - Fax:440-460-2885
Practice Address - Street 1:6551 WILSON MILLS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-3495
Practice Address - Country:US
Practice Address - Phone:440-460-2884
Practice Address - Fax:440-460-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty