Provider Demographics
NPI:1427001833
Name:COMPREHENSIVE CARE ANESTHESIA SERVICES INC
Entity Type:Organization
Organization Name:COMPREHENSIVE CARE ANESTHESIA SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKOLAIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-837-7200
Mailing Address - Street 1:PO BOX 74994
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-1077
Mailing Address - Country:US
Mailing Address - Phone:614-430-5724
Mailing Address - Fax:
Practice Address - Street 1:400 AUSTIN AVE NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-3554
Practice Address - Country:US
Practice Address - Phone:330-837-7200
Practice Address - Fax:330-837-7572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DB1218OtherMEDICARE RAILROAD
OH2468048Medicaid
DB1218OtherMEDICARE RAILROAD