Healthcare Provider Details

I. General information

NPI: 1922796861
Provider Name (Legal Business Name): COURTNEE L AMBOS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 WHITE POND DR
AKRON OH
44320-1155
US

IV. Provider business mailing address

701 WHITE POND DR
AKRON OH
44320-1155
US

V. Phone/Fax

Practice location:
  • Phone: 330-666-9769
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.017584
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: