1982394102 NPI number — MDREVIEW LLC

Table of content: (NPI 1982394102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982394102 NPI number — MDREVIEW LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MDREVIEW LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982394102
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
38095 FLANDERS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOLON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44139-6725
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-600-2880
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 COLUMBUS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44146-2819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-252-4130
Provider Business Practice Location Address Fax Number:
440-252-4132
Provider Enumeration Date:
05/10/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANAND
Authorized Official First Name:
LOKANATHAN
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE PROPRIETOR
Authorized Official Telephone Number:
440-600-2880

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)