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General NPI Number Information
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NPI Number | 1710393384
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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 | 07/03/2014
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 1320 CORPORATE DR #100
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City | HUDSON
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State | OH
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Zip | 44236-4442
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Country | US
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Telephone | 330-344-7650
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Fax | 330-344-3038
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Provider Business Mailing Address
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Address Line | 1320 CORPORATE DR #100
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City | HUDSON
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State | OH
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Zip | 44236-4442
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Country | US
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Telephone | 330-344-7650
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Fax | 330-344-3038
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | KENNETH J BRAMAN
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Credential | MD
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Telephone | 330-665-8302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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