Provider Demographics
NPI:1861831463
Name:GREAT LAKES HYPERTENSION & KIDNEY CARE INC
Entity Type:Organization
Organization Name:GREAT LAKES HYPERTENSION & KIDNEY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IONEL
Authorized Official - Middle Name:ZAMFIR
Authorized Official - Last Name:DONCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-463-9596
Mailing Address - Street 1:PO BOX 933335
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0037
Mailing Address - Country:US
Mailing Address - Phone:440-463-9596
Mailing Address - Fax:
Practice Address - Street 1:29640 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-1829
Practice Address - Country:US
Practice Address - Phone:440-463-9596
Practice Address - Fax:440-585-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35087500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty