Provider Demographics
NPI:1316077886
Name:UNIVERSITY PRIMARY CARE PRACTICES INC
Entity type:Organization
Organization Name:UNIVERSITY PRIMARY CARE PRACTICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF UH PHYSICIAN SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEGERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-844-5500
Mailing Address - Street 1:PO BOX 772040
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-2040
Mailing Address - Country:US
Mailing Address - Phone:440-461-6477
Mailing Address - Fax:440-466-1871
Practice Address - Street 1:1611 S GREEN RD
Practice Address - Street 2:STE 063
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4121
Practice Address - Country:US
Practice Address - Phone:216-237-5012
Practice Address - Fax:216-201-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9379335OtherMEDICARE PIN