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General NPI Number Information
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NPI Number | 1083730782
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Entity Type | Organization
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Legal Business Name | ADVANCED CONCEPTS IN ENDOSCOPY LLC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 7551 FREDLE DRIVE
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City | CONCORD
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State | OH
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Zip | 44077
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Country | US
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Telephone | 440-357-1474
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Fax | 440-357-1905
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Provider Business Mailing Address
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Address Line | 7551 FREDLE DRIVE
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City | CONCORD
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State | OH
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Zip | 44077
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Country | US
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Telephone | 440-357-1474
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Fax | 440-357-1905
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Authorized Official
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Title or Position | OWNER / PHYSICIAN
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Name | DORIS A MYERS
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Credential | DO
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Telephone | 440-350-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 34003594M
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License Number State | OH
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