Healthcare Provider Details

I. General information

NPI: 1508823204
Provider Name (Legal Business Name): PARMA PEDIATRICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6681 RIDGE ROAD SUITE 205
PARMA OH
44129-5713
US

IV. Provider business mailing address

6681 RIDGE ROAD SUITE 205
PARMA OH
44129-5713
US

V. Phone/Fax

Practice location:
  • Phone: 440-842-1121
  • Fax: 440-842-5676
Mailing address:
  • Phone: 440-842-1121
  • Fax: 440-842-5676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DIANE ARLENE BUTLER
Title or Position: OWNER
Credential: M.D.
Phone: 440-842-1121