Provider Demographics
NPI:1750451340
Name:MICHAEL A. RICH, M.D. AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:MICHAEL A. RICH, M.D. AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-454-8700
Mailing Address - Street 1:304 15TH ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44714-2523
Mailing Address - Country:US
Mailing Address - Phone:330-454-8700
Mailing Address - Fax:330-454-9836
Practice Address - Street 1:304 15TH ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-2523
Practice Address - Country:US
Practice Address - Phone:330-454-8700
Practice Address - Fax:330-454-9836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH658772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH28866711400OtherBUREAU OF WORKERS COMPENS
OH0971033Medicaid
OH28866711400OtherBUREAU OF WORKERS COMPENS
OH0971033Medicaid