Healthcare Provider Details

I. General information

NPI: 1831957414
Provider Name (Legal Business Name): STARK PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6659 FRANK AVE NW
NORTH CANTON OH
44720-7259
US

IV. Provider business mailing address

6659 FRANK AVE NW
NORTH CANTON OH
44720-7259
US

V. Phone/Fax

Practice location:
  • Phone: 330-623-7100
  • Fax: 330-232-9924
Mailing address:
  • Phone: 330-623-7100
  • Fax: 330-232-9924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. FREDA SARIF
Title or Position: MANAGER
Credential:
Phone: 330-623-7100