MEDICARE: DR. WILLIAM MIDIAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	046828	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	463753994	OTHER	OH	TAX ID

General Provider Information

NPI Number	:	1184626814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM MIDIAN M.D.

Provider Business Mailing Address
First Line	:	2417 MANCHESTER RD
Second Line	:	SUITE B
City	:	AKRON
State	:	OH
Zip	:	44314-3522
Country	:	US
Telephone Number	:	330-896-0900
Fax Number	:	330-848-3325

Provider Business Practice Location Address
First Line	:	2417 MANCHESTER RD
Second Line	:	SUITE B
City	:	AKRON
State	:	OH
Zip	:	44314-3522
Country	:	US
Telephone Number	:	330-896-0900
Fax Number	:	330-848-3325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	03/05/2014

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