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NPI Code Detail

MEDICARE: GASTROENTEROLOGY OF AKRON, INC.

MEDICARE: GASTROENTEROLOGY OF AKRON, 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
1207RG0100XGastroenterology Physician35-06-8779OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376732636
Entity Type Code : Organization
Provider Name (Legal Business Name) : GASTROENTEROLOGY OF AKRON, INC.
Provider Business Mailing Address
First Line : PO BOX 713056
Second Line :
City : CINCINNATI
State : OH
Zip : 45271
Country : US
Telephone Number : 330-535-3313
Fax Number : 330-535-1907
Provider Business Practice Location Address
First Line : 3939 S. CLEVELAND-MASSILLON RD
Second Line :
City : NORTON
State : OH
Zip : 44203-5611
Country : US
Telephone Number : 330-535-3313
Fax Number : 330-535-1907
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : MANZOOR QADIR
Credential : M.D.
Telephone Number : 330-535-3313
Provider Enumeration Date : 10/23/2007
Last Update Date : 09/05/2008

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