EASTSIDE MEDICAL GROUP NPI 1346625050

NPI Information

NPI: 1346625050
Provider Name: EASTSIDE MEDICAL GROUP
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 36D2213386

Address:
2775 S MORELAND BLVD
CLEVELAND, OH
ZIP 44120
Phone: (216) 751-8988
Get Directions

EASTSIDE MEDICAL GROUP is a multi-specialty clinic center in Cleveland, OH. EASTSIDE MEDICAL GROUP NPI is 1346625050. The provider is registered as an organization entity type.

The provider's business location address is:

2775 S MORELAND BLVD
CLEVELAND, OH
ZIP 44120-397
Phone: (216) 751-8988
Fax: (216) 751-8990

The provider's authorized official is Lauchlin Mckeigan .
The authorized official title is Owner and has the following contact phone number (440) 725-8984.

The CLIA number assigned to this NPI record is 36D2213386 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/23/2015 and was last updated on 6/21/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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