Provider Demographics
NPI:1942668306
Name:CLEVELAND SHOULDER INSTITUTE LLC
Entity Type:Organization
Organization Name:CLEVELAND SHOULDER INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOBEZIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-995-2767
Mailing Address - Street 1:1000 AUBURN DR # 200
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4317
Mailing Address - Country:US
Mailing Address - Phone:440-995-2767
Mailing Address - Fax:216-201-6364
Practice Address - Street 1:6780 MAYFIELD RD # 415
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2203
Practice Address - Country:US
Practice Address - Phone:440-995-2767
Practice Address - Fax:216-201-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier