Healthcare Provider Details

I. General information

NPI: 1710925557
Provider Name (Legal Business Name): DEAN RICH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 MANCHESTER RD
AKRON OH
44314-3522
US

IV. Provider business mailing address

2417 MANCHESTER RD
AKRON OH
44314-3522
US

V. Phone/Fax

Practice location:
  • Phone: 330-848-3377
  • Fax: 330-848-3325
Mailing address:
  • Phone: 330-848-3377
  • Fax: 330-848-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.004672
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: