Doctor Name: | DR. ERNEST JOHN CAMPONOVO |
NPI Number: | 1588661904 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD042369L |
Business Practice Address: | 3700 Park East Drive Suite 450 Beachwood, OH - 441224305 |
Business Phone Number: | 8552921401 |
Business Fax Number: | 8663938340 |
Mailing Address: | 3700 Park East Drive, Suite 450 BEACHWOOD |
State: | OH |
Postal Code: | 441224305 |
Phone Number: | 8552921401 |
Fax Number: | 8663938340 |
NPI Enumeration Date: | 06/30/2005 |
NPI Last Update Date: | 05/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD042369L |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |