| St Judes Medical Clinic | |
|
7211 Broadway Cleveland OH 44105 | |
| (216) 271-1947 | |
| (216) 271-0106 |
| Full Name | St Judes Medical Clinic |
|---|---|
| Speciality | General Practice |
| Location | 7211 Broadway, Cleveland, Ohio |
| Authorized Official Name and Position | Nelida R Enrique (PRESIDENT TREASURER) |
| Authorized Official Contact | 2162711947 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Judes Medical Clinic 7211 Broadway Cleveland OH 44105 Ph: (216) 271-1947 | St Judes Medical Clinic 7211 Broadway Cleveland OH 44105 Ph: (216) 271-1947 |
| NPI Number | 1609884592 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 02/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609884592 | NPI | - | NPPES |
| 0325866 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 35033404 (Ohio) | Primary |
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