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NPI Code Detail

MEDICARE: BRIAN R CAIN M.D.

MEDICARE:   BRIAN R CAIN  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
1207Q00000XFamily Medicine Physician35-061748OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19338635OTHEROHPARTNERS PHYSICIAN GROUP MEDICARE GROUP #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41083864144OTHEROHPORTAGE HILL TYPE 2 NPI #
51841239274OTHEROHPARTNERS PHYSICIAN GROUP TYPE 2 NPI #

General Provider Information

NPI Number : 1417951039
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN R CAIN M.D.
Provider Business Mailing Address
First Line : 754 S CLEVELAND AVE STE 300
Second Line :
City : MOGADORE
State : OH
Zip : 44260-2210
Country : US
Telephone Number : 330-877-3008
Fax Number : 330-877-3032
Provider Business Practice Location Address
First Line : 754 S CLEVELAND AVE STE 300
Second Line :
City : MOGADORE
State : OH
Zip : 44260-2210
Country : US
Telephone Number : 330-877-3008
Fax Number : 330-877-3032
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 09/17/2020

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Directions to “ BRIAN R CAIN M.D.” Practice Location

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