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General NPI Number Information
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NPI Number | 1831362755
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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 | 04/11/2008
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 4302 ALLEN RD #140
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City | STOW
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State | OH
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Zip | 44224-1070
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Country | US
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Telephone | 330-665-8270
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Fax | 330-344-1004
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Provider Business Mailing Address
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Address Line | 4302 ALLEN RD #140
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City | STOW
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State | OH
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Zip | 44224-1070
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Country | US
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Telephone | 330-665-8270
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Fax | 330-344-1004
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | KENNETH BRAMAN
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Credential | DO
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | OH
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