Provider Demographics
NPI:1033688908
Name:ANTONY M GEORGE MD MPH LLC
Entity Type:Organization
Organization Name:ANTONY M GEORGE MD MPH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-249-7078
Mailing Address - Street 1:7225 OLD OAK BLVD STE A210
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3339
Mailing Address - Country:US
Mailing Address - Phone:440-249-7078
Mailing Address - Fax:440-816-4336
Practice Address - Street 1:5109 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2405
Practice Address - Country:US
Practice Address - Phone:440-249-7078
Practice Address - Fax:440-816-4336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTONY M GEORGE MD MPH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty