Provider Demographics
NPI:1003808080
Name:PELINI, MICHAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:PELINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:168 E MARKET ST
Mailing Address - Street 2:PO BOX 3542
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-2038
Mailing Address - Country:US
Mailing Address - Phone:330-376-7000
Mailing Address - Fax:330-376-1066
Practice Address - Street 1:95 ARCH ST
Practice Address - Street 2:STE 300
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1473
Practice Address - Country:US
Practice Address - Phone:330-376-7000
Practice Address - Fax:330-376-1066
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35078429P207RC0000X
OH35078429207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2203332Medicaid
OH4026496OtherMEDICARE ID
OH4026496OtherMEDICARE ID