Provider Demographics
NPI:1093822454
Name:INTERNAL MEDICINE SPECIALISTS, INC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:IEMMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-923-0553
Mailing Address - Street 1:96 GRAHAM RD STE B
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-1205
Mailing Address - Country:US
Mailing Address - Phone:330-923-0553
Mailing Address - Fax:330-923-0199
Practice Address - Street 1:96 GRAHAM RD STE B
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1205
Practice Address - Country:US
Practice Address - Phone:330-923-0553
Practice Address - Fax:330-923-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2242193Medicaid
OH2242193Medicaid
OH978612Medicare ID - Type Unspecified