Healthcare Provider Details

I. General information

NPI: 1720159825
Provider Name (Legal Business Name): ERIN BEIRNE FAIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 S TRIMBLE RD
MANSFIELD OH
44906-3427
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 419-522-3341
  • Fax: 419-522-1110
Mailing address:
  • Phone: 419-522-3341
  • Fax: 419-522-1110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.063391
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: