Healthcare Provider Details

I. General information

NPI: 1568574515
Provider Name (Legal Business Name): STEPHEN GREGORY KAISER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N MAIN ST SUMMA CENTER FOR CORPORATE HEALTH
AKRON OH
44310-3110
US

IV. Provider business mailing address

444 N MAIN ST SUMMA CENTER FOR CORPORATE HEALTH
AKRON OH
44310-3110
US

V. Phone/Fax

Practice location:
  • Phone: 330-379-5959
  • Fax: 330-379-5902
Mailing address:
  • Phone: 330-379-5959
  • Fax: 330-379-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number34.002291
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: