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NPI Code Detail

MEDICARE: SENYO AGIDI DO

MEDICARE: SENYO AGIDI DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine Physician58007216OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11487037131OTHERNPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487037131
Entity Type Code : Individual
Provider Name (Legal Business Name) : SENYO AGIDI DO
Provider Business Mailing Address
First Line : 75 ARCH ST STE 302
Second Line :
City : AKRON
State : OH
Zip : 44304-1432
Country : US
Telephone Number : 330-253-5088
Fax Number : 330-253-5095
Provider Business Practice Location Address
First Line : 75 ARCH ST STE 302
Second Line :
City : AKRON
State : OH
Zip : 44304-1432
Country : US
Telephone Number : 330-253-5088
Fax Number : 330-253-5095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2015
Last Update Date : 11/11/2018

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Directions to “ SENYO AGIDI DO” Practice Location

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