Provider Demographics
NPI:1245221415
Name:CLEVELAND ORTHOPAEDIC ASSOCIATES INC
Entity Type:Organization
Organization Name:CLEVELAND ORTHOPAEDIC ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-332-0887
Mailing Address - Street 1:5706 TURNEY RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-3971
Mailing Address - Country:US
Mailing Address - Phone:216-332-0887
Mailing Address - Fax:216-332-0875
Practice Address - Street 1:5706 TURNEY RD
Practice Address - Street 2:SUITE 107
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-3971
Practice Address - Country:US
Practice Address - Phone:216-332-0887
Practice Address - Fax:216-332-0875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207X00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0310256Medicaid
OH9916101Medicare PIN
OH0174740001Medicare NSC
OHCB7426Medicare PIN