| Pivo Physiq, Inc., | |
|
11201 Shaker Blvd Suite 328 Cleveland OH 44104-3869 | |
| (216) 881-5055 | |
| (216) 881-5855 |
| Full Name | Pivo Physiq, Inc., |
|---|---|
| Speciality | Internal Medicine |
| Location | 11201 Shaker Blvd, Cleveland, Ohio |
| Authorized Official Name and Position | Toye G.c. Williams (PHYSICIAN) |
| Authorized Official Contact | 2168815055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pivo Physiq, Inc., 2000 Marlindale Rd Cleveland OH 44118-2513 Ph: (216) 252-0054 | Pivo Physiq, Inc., 11201 Shaker Blvd Suite 328 Cleveland OH 44104-3869 Ph: (216) 881-5055 |
| NPI Number | 1740449990 |
|---|---|
| Provider Enumeration Date | 06/03/2008 |
| Last Update Date | 06/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740449990 | NPI | - | NPPES |
| 0898695 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35-064135 (Ohio) | Primary |
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