Healthcare Provider Details

I. General information

NPI: 1619249612
Provider Name (Legal Business Name): REPRODUCTIVE GYNECOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W. TUSCARAWUS ST SUITE 560
CANTON OH
44708
US

IV. Provider business mailing address

95 ARCH ST STE 250
AKRON OH
44304
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-7782
  • Fax: 330-253-6708
Mailing address:
  • Phone: 330-452-6010
  • Fax: 330-454-8538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number350421094M
License Number StateOH

VIII. Authorized Official

Name: DR. RICHARD W MORETUZZO
Title or Position: OWNER
Credential: MD
Phone: 330-375-7722