Provider Demographics
NPI:1619983442
Name:PARMA FAMILY PRACTICE INC
Entity Type:Organization
Organization Name:PARMA FAMILY PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CHAGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-845-6700
Mailing Address - Street 1:6681 RIDGE RD
Mailing Address - Street 2:STE 209
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5705
Mailing Address - Country:US
Mailing Address - Phone:440-845-6700
Mailing Address - Fax:440-843-1831
Practice Address - Street 1:6681 RIDGE RD
Practice Address - Street 2:STE 209
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5705
Practice Address - Country:US
Practice Address - Phone:440-845-6700
Practice Address - Fax:440-843-1831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH63947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2726143Medicaid
OHDG1564Medicare PIN
OH9365851Medicare PIN