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General NPI Number Information
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NPI Number | 1902932353
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Entity Type | Organization
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Legal Business Name | DIGESTIVE WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 3939 SOUTH CLEVELAND-MASSILLON ROAD
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City | NORTON
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State | OH
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Zip | 44203
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Country | US
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Telephone | 330-237-1058
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Fax | 330-237-1059
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Provider Business Mailing Address
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Address Line | 3939 CLEVELAND MASSILLON RD
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City | NORTON
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State | OH
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Zip | 44203-5611
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Country | US
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Telephone | 330-237-1058
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Fax | 330-237-1059
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | GHULAM N. MIR
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Credential | MD
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Telephone | 330-753-6643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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