Provider Demographics
NPI:1225221294
Name:EDDE CINTI MD INC
Entity type:Organization
Organization Name:EDDE CINTI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDE
Authorized Official - Middle Name:
Authorized Official - Last Name:CINTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-542-6841
Mailing Address - Street 1:30575 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1037
Mailing Address - Country:US
Mailing Address - Phone:440-516-3776
Mailing Address - Fax:440-516-3783
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:SUITE 550
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2964
Practice Address - Country:US
Practice Address - Phone:440-542-6841
Practice Address - Fax:440-542-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35031748207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2882706Medicaid
OH000000164445OtherANTHEM BLUE SHIELD
OH2882706Medicaid
OH9378451Medicare PIN