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General NPI Number Information
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NPI Number | 1487919734
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Entity Type | Organization
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Legal Business Name | AFFINITY MEDICAL CENTER
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 875 8TH ST NE
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City | MASSILLON
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State | OH
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Zip | 44646-8503
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Country | US
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Telephone | 330-834-4784
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Fax |
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Provider Business Mailing Address
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Address Line | 345 SHERATON DR NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-2268
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EMERGENCY MEDICINE RESIDENT PHYSICI
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Name | DR. PHUC NGUYEN
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Credential | D.O
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Telephone | 703-819-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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