MEDICARE: AKRON WOMAN'S MEDICAL GROUP, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790815892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKRON WOMAN'S MEDICAL GROUP, INC

Provider Business Mailing Address
First Line	:	839 E MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-2460
Country	:	US
Telephone Number	:	330-535-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	839 E MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-2460
Country	:	US
Telephone Number	:	330-535-9191
Fax Number	:

Authorized Official
Title or Position	:	EX DIRECTOR
Name	:	CAROL WESTFALL
Credential	:
Telephone Number	:	216-295-3330

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	08/22/2020

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