Healthcare Provider Details

I. General information

NPI: 1881644698
Provider Name (Legal Business Name): RICHARD ADAM BELL CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 01/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 E MARKET ST
WARREN OH
44483-6608
US

IV. Provider business mailing address

3622 BELMONT AVE SUITE 1
YOUNGSTOWN OH
44505-1450
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-9230
  • Fax: 330-841-9571
Mailing address:
  • Phone: 330-759-9350
  • Fax: 330-759-9387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN273098
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: