Healthcare Provider Details

I. General information

NPI: 1982940847
Provider Name (Legal Business Name): THE UNIVERSITY OF AKRON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2012
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 BUCHTEL COMMON STUDENT HEALTH SERVICES, SRWC, SUITE 260
AKRON OH
44325-1101
US

IV. Provider business mailing address

302 BUCHTEL COMMON STUDENT HEALTH SERVICES, SRWC, SUITE 260
AKRON OH
44325-1101
US

V. Phone/Fax

Practice location:
  • Phone: 330-972-7808
  • Fax: 330-972-8849
Mailing address:
  • Phone: 330-972-7808
  • Fax: 330-972-8849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: WILLIAM MICHAEL SHERMAN
Title or Position: SR. VP/PROVOST/COO
Credential:
Phone: 330-972-7593