Provider Demographics
NPI:1477645935
Name:INTERNAL MEDICINE OF AKRON
Entity Type:Organization
Organization Name:INTERNAL MEDICINE OF AKRON
Other - Org Name:PARTNERS PHYSICIAN GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, FINANCE, OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-344-6095
Mailing Address - Street 1:75 ARCH ST
Mailing Address - Street 2:STE. 501
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1429
Mailing Address - Country:US
Mailing Address - Phone:330-376-1046
Mailing Address - Fax:330-376-0130
Practice Address - Street 1:75 ARCH ST
Practice Address - Street 2:STE. 501
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1429
Practice Address - Country:US
Practice Address - Phone:330-376-1046
Practice Address - Fax:330-376-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID #
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE #