Healthcare Provider Details

I. General information

NPI: 1336256247
Provider Name (Legal Business Name): COMPREHENSIVE INTERNAL MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 FRIENDSVILLE RD SUITE 2
WOOSTER OH
44691-7131
US

IV. Provider business mailing address

3727 FRIENDSVILLE RD SUITE 2
WOOSTER OH
44691-7131
US

V. Phone/Fax

Practice location:
  • Phone: 330-202-3444
  • Fax: 330-202-3435
Mailing address:
  • Phone: 330-202-3444
  • Fax: 330-202-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBRA FAST
Title or Position: PRESIDENT
Credential: DO
Phone: 330-202-3444