Provider Demographics
NPI:1790956191
Name:WARREN MEDICAL SPECIALISTS INC
Entity Type:Organization
Organization Name:WARREN MEDICAL SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHUIRAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-609-5089
Mailing Address - Street 1:9375 E MARKET ST
Mailing Address - Street 2:STE1
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5552
Mailing Address - Country:US
Mailing Address - Phone:330-609-5089
Mailing Address - Fax:330-609-6634
Practice Address - Street 1:9375 E MARKET ST
Practice Address - Street 2:STE1
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5552
Practice Address - Country:US
Practice Address - Phone:330-609-5089
Practice Address - Fax:330-609-6634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4021501Medicare PIN