Healthcare Provider Details

I. General information

NPI: 1720287923
Provider Name (Legal Business Name): CENTER FOR VASCULAR ACCESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8423 MARKET ST SUITE 210
BOARDMAN OH
44512-6778
US

IV. Provider business mailing address

8423 MARKET ST SUITE 210
BOARDMAN OH
44512-6778
US

V. Phone/Fax

Practice location:
  • Phone: 330-629-2855
  • Fax: 330-629-2859
Mailing address:
  • Phone: 330-629-2855
  • Fax: 330-629-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHERIF A SOLIMAN
Title or Position: MANAGING PHYSICIAN
Credential: MD
Phone: 330-629-2855