Healthcare Provider Details

I. General information

NPI: 1245501675
Provider Name (Legal Business Name): DR. MICHAEL JOHN VAPORIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2012
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S ARLINGTON ST UNIT 38
AKRON OH
44306-3771
US

IV. Provider business mailing address

1400 S ARLINGTON ST UNIT 38
AKRON OH
44306-3771
US

V. Phone/Fax

Practice location:
  • Phone: 330-724-5471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number19613
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: