Healthcare Provider Details

I. General information

NPI: 1699989392
Provider Name (Legal Business Name): MICHAEL JOHN LYNCH MD, JD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SIXTH ST SW
CANTON OH
44710-1702
US

IV. Provider business mailing address

PO BOX 80690
CANTON OH
44708-0690
US

V. Phone/Fax

Practice location:
  • Phone: 330-492-9911
  • Fax:
Mailing address:
  • Phone: 330-363-7444
  • Fax: 333-363-7770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.085297
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: