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NPI Code Detail

MEDICARE: EMERGENCY PHYSICIANS MEDICAL GROUP, INC

MEDICARE: EMERGENCY PHYSICIANS MEDICAL GROUP, 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
1207P00000XEmergency Medicine Physician

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 : 1588604383
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMERGENCY PHYSICIANS MEDICAL GROUP, INC
Provider Business Mailing Address
First Line : 4535 DRESSLER RD NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2545
Country : US
Telephone Number : 330-493-4443
Fax Number : 330-493-8677
Provider Business Practice Location Address
First Line : 768 MOUNTAIN RANCH RD
Second Line :
City : SAN ANDREAS
State : CA
Zip : 95249-9707
Country : US
Telephone Number : 330-493-4443
Fax Number : 330-493-8677
Authorized Official
Title or Position : PRESIDENT
Name : NORMAN LABEL
Credential : MD
Telephone Number : 330-493-4443
Provider Enumeration Date : 06/08/2006
Last Update Date : 10/24/2007

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