Organization Name: | NORTHERN OHIO MEDICAL SPECIALISTS, LLC |
NPI Number: | 1508811332 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSHUA FREDERICK (CEO) |
Mailing Address: | 5319 Hoag Dr Suite 130 Sheffield Village |
State: | OH US |
Postal Code: | 440351494 |
Phone Number: | 4409306020 |
Fax Number: | 4409341082 |
NPI Enumeration Date: | 05/23/2006 |
NPI Last Update Date: | 09/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | 35072484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |