Provider Demographics
NPI:1508865213
Name:SURMITIS, JOSEPH MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:SURMITIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4082 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2866
Mailing Address - Country:US
Mailing Address - Phone:330-497-7100
Mailing Address - Fax:330-497-7010
Practice Address - Street 1:7337 CARITAS CIR NW STE 200
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9127
Practice Address - Country:US
Practice Address - Phone:330-481-1286
Practice Address - Fax:330-481-1273
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35052232207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH742012Medicaid
OHSU4028285Medicare ID - Type Unspecified
OH742012Medicaid