MEDICARE: GASTROENTEROLOGY 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
1	174400000X	Specialist	350611685	OH

General Provider Information

NPI Number	:	1689670978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTROENTEROLOGY GROUP INC

Provider Business Mailing Address
First Line	:	570 WHITE POND DRIVE
Second Line	:	SUITE #200
City	:	AKRON
State	:	OH
Zip	:	44320
Country	:	US
Telephone Number	:	330-869-0954
Fax Number	:	330-869-0964

Provider Business Practice Location Address
First Line	:	570 WHITE POND DR
Second Line	:	STE 200
City	:	AKRON
State	:	OH
Zip	:	44320-4208
Country	:	US
Telephone Number	:	330-869-0954
Fax Number	:	330-869-0964

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SCOTT FULTON
Credential	:	MD
Telephone Number	:	330-869-0954

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/14/2023

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Directions to “GASTROENTEROLOGY GROUP INC ” Practice Location

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