| Cedarnile Llc | |
|
14805 Detroit Ave Lakewood OH 44107-3934 | |
| (330) 576-5600 | |
| Not Available |
| Full Name | Cedarnile Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 14805 Detroit Ave, Lakewood, Ohio |
| Authorized Official Name and Position | Samir Joseph Shaia (PARTNERSHIP) |
| Authorized Official Contact | 3305675600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedarnile Llc Po Box 1243 Bath OH 44210-1243 Ph: (330) 576-5600 | Cedarnile Llc 14805 Detroit Ave Lakewood OH 44107-3934 Ph: (330) 576-5600 |
| NPI Number | 1942530506 |
|---|---|
| Provider Enumeration Date | 01/05/2010 |
| Last Update Date | 01/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942530506 | NPI | - | NPPES |
| 2474979 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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