Provider Demographics
NPI:1780857151
Name:PARTNERS PHYSICIAN GROUP
Entity Type:Organization
Organization Name:PARTNERS PHYSICIAN GROUP
Other - Org Name:AKRON GENERAL ARTHRITIS & RHEUMATOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER, PPG
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-665-8302
Mailing Address - Street 1:4302 ALLEN RD
Mailing Address - Street 2:#210
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1070
Mailing Address - Country:US
Mailing Address - Phone:330-344-7820
Mailing Address - Fax:330-928-4320
Practice Address - Street 1:4302 ALLEN RD
Practice Address - Street 2:#210
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1070
Practice Address - Country:US
Practice Address - Phone:330-344-7820
Practice Address - Fax:330-928-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE #
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #