Provider Demographics
NPI:1245207356
Name:CLEVELAND PEDIATRICS PC
Entity Type:Organization
Organization Name:CLEVELAND PEDIATRICS PC
Other - Org Name:PAULA FRANKLIN MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-278-0300
Mailing Address - Street 1:PO BOX 1907
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28145-1907
Mailing Address - Country:US
Mailing Address - Phone:704-636-8668
Mailing Address - Fax:704-633-4970
Practice Address - Street 1:11709 STATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:NC
Practice Address - Zip Code:27013-9418
Practice Address - Country:US
Practice Address - Phone:704-278-0300
Practice Address - Fax:704-278-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901176208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891241EMedicaid
NC1241EOtherBCBS OF NC
=========OtherALL COMMERICAL CARRIERS