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General NPI Number Information
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NPI Number | 1528007309
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Entity Type | Organization
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Legal Business Name | PARTNERS PHYSICIAN GROUP
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 140 WADSWORTH RD
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City | WADSWORTH
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State | OH
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Zip | 44281-9503
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Country | US
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Telephone | 330-334-2555
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Fax | 330-334-2557
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Provider Business Mailing Address
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Address Line | 3428 W MARKET ST SUITE 103
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City | FAIRLAWN
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State | OH
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Zip | 44333-3339
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Country | US
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Telephone | 330-344-4033
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Fax | 330-896-8018
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ALAN J PAPA
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Credential |
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Telephone | 330-344-2131
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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 |
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License Number State |
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