| NPI | 1851377949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CHARLES DEMIDOVICH President 330-533-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2019-05-29 |