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General NPI Number Information
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NPI Number | 1881868164
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Entity Type | Organization
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Legal Business Name | WOODLAND EMERGENCY PHYSICIANS MEDICAL GROUP INC
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 1325 COTTONWOOD ST
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City | WOODLAND
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State | CA
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Zip | 95695-5131
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Country | US
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Telephone | 855-687-0618
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Fax |
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Provider Business Mailing Address
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Address Line | 4535 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2545
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Country | US
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Telephone | 855-687-0618
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Fax | 330-994-4409
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN P. MARON
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Credential | M.D.
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Telephone | 855-687-0618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | CA
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