Provider Demographics
NPI:1700160652
Name:METRO HEALTH MEDICAL CENTER
Entity type:Organization
Organization Name:METRO HEALTH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SARVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-210-3926
Mailing Address - Street 1:19460 KNOWLTON PARK WAY
Mailing Address - Street 2:APT # 205
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-9053
Mailing Address - Country:US
Mailing Address - Phone:951-210-3926
Mailing Address - Fax:
Practice Address - Street 1:19460 KNOWLTON PKWY
Practice Address - Street 2:APT # 205
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44149-9053
Practice Address - Country:US
Practice Address - Phone:951-210-3926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57. 019220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH543323100OtherMEDICAL MUTUAL