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General NPI Number Information
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NPI Number | 1417016973
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Entity Type | Organization
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Legal Business Name | OHIO PHYSICIAN PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2600 SIXTH ST SW
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City | CANTON
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State | OH
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Zip | 44710-1702
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Country | US
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Telephone | 330-479-8705
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80690
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City | CANTON
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State | OH
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Zip | 44708-0690
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Country | US
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Telephone | 330-479-8705
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Fax | 330-479-9330
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW STEWART
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Credential |
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Telephone | 330-363-4472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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