Provider Demographics
NPI:1780963843
Name:CLEVELAND EAR NOSE THROAT, INC
Entity type:Organization
Organization Name:CLEVELAND EAR NOSE THROAT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-461-0150
Mailing Address - Street 1:6770 MAYFIELD RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2299
Mailing Address - Country:US
Mailing Address - Phone:440-461-0150
Mailing Address - Fax:440-461-8221
Practice Address - Street 1:6770 MAYFIELD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-461-0150
Practice Address - Fax:440-461-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty