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NPI Code Detail

MEDICARE: ALLENSIDE FAMILY PRACTICE

MEDICARE: ALLENSIDE FAMILY PRACTICE
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 Physician34004672OH

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 : 1871570622
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLENSIDE FAMILY PRACTICE
Provider Business Mailing Address
First Line : 2417 MANCHESTER RD
Second Line :
City : AKRON
State : OH
Zip : 44314
Country : US
Telephone Number : 330-848-3377
Fax Number : 330-848-3325
Provider Business Practice Location Address
First Line : 2417 MANCHESTER RD
Second Line :
City : AKRON
State : OH
Zip : 44314
Country : US
Telephone Number : 330-848-3377
Fax Number : 330-848-3325
Authorized Official
Title or Position : PHYSICIAN
Name : DR. DEAN PATRICK RICH
Credential : DO
Telephone Number : 330-848-3377
Provider Enumeration Date : 12/22/2005
Last Update Date : 01/11/2010

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Directions to “ALLENSIDE FAMILY PRACTICE ” Practice Location

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