| NPI | 1861892879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CHASTAIN Provider Enrollment 330-493-4443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD R183795) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2024-12-17 |