Healthcare Provider Details

I. General information

NPI: 1861686206
Provider Name (Legal Business Name): COMPREHENSIVE CARE ANESTHESIA SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 AARONWOOD AVE NE AFFINITY PAIN CENTER
MASSILLON OH
44646-2371
US

IV. Provider business mailing address

PO BOX 74994
CLEVELAND OH
44194-0001
US

V. Phone/Fax

Practice location:
  • Phone: 330-834-4788
  • Fax:
Mailing address:
  • Phone: 614-430-5724
  • Fax: 614-430-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANK NIKOLAIDIS
Title or Position: PRESIDENT
Credential: DO
Phone: 330-837-7200