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General NPI Number Information
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NPI Number | 1730995721
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Entity Type | Organization
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Legal Business Name | AZIMUTH MEDICAL LLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 1701 MENTOR AVE STE 10
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City | PAINESVILLE
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State | OH
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Zip | 44077-1459
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Country | US
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Telephone | 440-364-7590
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 MENTOR AVE STE 10
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City | PAINESVILLE
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State | OH
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Zip | 44077-1459
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Country | US
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Telephone | 440-364-7590
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALISTS
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Name | MEGHAN SCHOFIELD
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Credential |
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Telephone | 440-478-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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