Healthcare Provider Details

I. General information

NPI: 1932170644
Provider Name (Legal Business Name): FAMILY MEDICINE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 E. WASHINGTON STREET SUITE 301
MEDINA OH
44256-3332
US

IV. Provider business mailing address

970 E. WASHINGTON STREET SUITE 301
MEDINA OH
44256-3332
US

V. Phone/Fax

Practice location:
  • Phone: 330-725-8441
  • Fax: 330-725-8442
Mailing address:
  • Phone: 330-725-8441
  • Fax: 330-725-8442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOANN SABOL
Title or Position: OFFICE MANAGER
Credential: R.N.
Phone: 330-725-8441