Healthcare Provider Details
I. General information
NPI: 1548207111
Provider Name (Legal Business Name): PARTNERS PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2006
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
676 S BROADWAY ST
AKRON OH
44311-1059
US
IV. Provider business mailing address
676 S BROADWAY ST
AKRON OH
44311-1059
US
V. Phone/Fax
- Phone: 330-344-4000
- Fax: 330-253-2349
- Phone: 330-344-4000
- Fax: 330-253-2349
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KENNETH
BRAMAN
Title or Position: CHIEF MEDICAL OFFICER
Credential: DO
Phone: 330-665-8302