| Southwest General Medical Group, Inc. | |
|
7265 Old Oak Blvd Cleveland OH 44130-3342 | |
| (440) 816-5790 | |
| Not Available |
| Full Name | Southwest General Medical Group, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 7265 Old Oak Blvd, Cleveland, Ohio |
| Authorized Official Name and Position | Heather Wagner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4408164906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest General Medical Group, Inc. Po Box 638269 Cincinnati OH 45263-0001 Ph: (440) 816-5790 | Southwest General Medical Group, Inc. 7265 Old Oak Blvd Cleveland OH 44130-3342 Ph: (440) 816-5790 |
| NPI Number | 1588713341 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 05/11/2020 |
| Certification Date | 05/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588713341 | NPI | - | NPPES |
| DA4203 | Other | OH | RAILROAD MEDICARE |
| 2238144 | Medicaid | OH | |
| 2238180 | Medicaid | OH | |
| CA1078 | Other | OH | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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