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General NPI Number Information
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NPI Number | 1821043704
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Entity Type | Individual
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Provider Name | JAMES FOSTER GROW JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 605 N CLEVELAND MASSILLON RD STE. B
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City | FAIRLAWN
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State | OH
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Zip | 44333-2241
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Country | US
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Telephone | 330-666-3333
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Fax | 330-668-6532
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Provider Business Mailing Address
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Address Line | 605 N CLEVELAND MASSILLON RD STE. B
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City | FAIRLAWN
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State | OH
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Zip | 44333-2241
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Country | US
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Telephone | 330-666-3333
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Fax | 330-668-6532
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 35.030368
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License Number State | OH
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