Provider Demographics
NPI:1194818237
Name:CARDIOLOGY ASSOCIATES OF CLEVELAND, INC.
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF CLEVELAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-475-5370
Mailing Address - Street 1:12000 MCCRACKEN RD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125
Mailing Address - Country:US
Mailing Address - Phone:216-475-5370
Mailing Address - Fax:216-475-5125
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:SUITE 460
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:216-475-5370
Practice Address - Fax:216-475-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCA9923451Medicare ID - Type Unspecified