MEDICARE: SURGICAL ASSOCIATES OF CANTON, INC.

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	208600000X	Surgery Physician

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

General Provider Information

NPI Number	:	1336127091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL ASSOCIATES OF CANTON, INC.

Provider Business Mailing Address
First Line	:	2600 TUSCARAWAS ST W
Second Line	:	SUITE 620
City	:	CANTON
State	:	OH
Zip	:	44708-4644
Country	:	US
Telephone Number	:	330-455-8000
Fax Number	:	330-455-6006

Provider Business Practice Location Address
First Line	:	2600 TUSCARAWAS ST W
Second Line	:	SUITE 620
City	:	CANTON
State	:	OH
Zip	:	44708-4644
Country	:	US
Telephone Number	:	330-455-8000
Fax Number	:	330-455-6006

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TODD MEYERHOEFER
Credential	:	MD
Telephone Number	:	330-455-8000

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	12/19/2007

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