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General NPI Number Information
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NPI Number | 1770896268
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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 | 07/26/2010
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 33 NORTH AVE #104
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City | TALLMADGE
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State | OH
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Zip | 44278-1925
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Country | US
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Telephone | 330-344-3990
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Fax | 330-634-9433
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Provider Business Mailing Address
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Address Line | 33 NORTH AVE #104
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City | TALLMADGE
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State | OH
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Zip | 44278-1925
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Country | US
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Telephone | 330-344-3990
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Fax | 330-634-9433
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER, PPG
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Name | KENNETH BRAMAN
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Credential |
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | OH
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