Provider Demographics
NPI:1699044255
Name:UNIVERSITY HOSPITALS CASE MEDICAL CENTER/CWRU
Entity type:Organization
Organization Name:UNIVERSITY HOSPITALS CASE MEDICAL CENTER/CWRU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXERCISE PHYSIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:JEREMY
Authorized Official - Last Name:FIUTEM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RCEP, CES
Authorized Official - Phone:216-844-1624
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:RBC # 637-PEDIATRIC CARDIOLOGY
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-1624
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:RBC # 637-PEDIATRIC CARDIOLOGY
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-1624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Single Specialty