Provider Demographics
NPI:1235255316
Name:UNIVERSITY PRIMARY CARE PRACTICES INC
Entity Type:Organization
Organization Name:UNIVERSITY PRIMARY CARE PRACTICES INC
Other - Org Name:UHMP - NEUROLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:UHPS PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
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:440-974-4211
Mailing Address - Fax:440-974-4273
Practice Address - Street 1:18599 LAKE SHORE BLVD
Practice Address - Street 2:STE 500
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1093
Practice Address - Country:US
Practice Address - Phone:216-383-7850
Practice Address - Fax:216-383-7988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4252080021Medicare NSC
OH9332067Medicare PIN