Healthcare Provider Details

I. General information

NPI: 1003808080
Provider Name (Legal Business Name): MICHAEL A PELINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ARCH ST STE 300
AKRON OH
44304-1473
US

IV. Provider business mailing address

168 E MARKET ST PO BOX 3542
AKRON OH
44308-2038
US

V. Phone/Fax

Practice location:
  • Phone: 330-376-7000
  • Fax: 330-376-1066
Mailing address:
  • Phone: 330-376-7000
  • Fax: 330-376-1066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35078429P
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35078429
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: