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General NPI Number Information
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NPI Number | 1114026226
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY ONE, INC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 4466 FULTON DR NW
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City | CANTON
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State | OH
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Zip | 44718-2864
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Country | US
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Telephone | 330-489-1386
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Fax | 330-526-0069
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Provider Business Mailing Address
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Address Line | 4466 FULTON DR NW
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City | CANTON
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State | OH
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Zip | 44718-2864
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Country | US
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Telephone | 330-489-1386
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Fax | 330-526-0127
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHAMAD S KASSIR
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Credential | M.D
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Telephone | 330-489-1386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0980710
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License Number State | OH
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