Healthcare Provider Details

I. General information

NPI: 1275816688
Provider Name (Legal Business Name): MICHAEL J OROS MD MBA LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 10/17/2021
Certification Date: 10/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 CLEVELAND AVE NW STE 150
NORTH CANTON OH
44720-9834
US

IV. Provider business mailing address

9701 CLEVELAND AVE NW STE 150
NORTH CANTON OH
44720-9834
US

V. Phone/Fax

Practice location:
  • Phone: 330-913-7109
  • Fax: 330-913-7192
Mailing address:
  • Phone: 330-913-7109
  • Fax: 646-390-1330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number35.094367
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.094367
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35.094367
License Number StateOH

VIII. Authorized Official

Name: DR. MICHAEL J OROS
Title or Position: MEMBER
Credential: MD, MBA
Phone: 330-913-7109