Provider Demographics
NPI:1942398656
Name:MORNINGSTAR HEMATOLOGY AND ONCOLOGY ASSOCIATES, INC
Entity Type:Organization
Organization Name:MORNINGSTAR HEMATOLOGY AND ONCOLOGY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SCHMOTZER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:330-453-3309
Mailing Address - Street 1:2600 6TH ST SW
Mailing Address - Street 2:CANCER CENTER
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710
Mailing Address - Country:US
Mailing Address - Phone:330-453-3309
Mailing Address - Fax:330-363-7413
Practice Address - Street 1:2600 6TH ST SW
Practice Address - Street 2:CANCER CENTER
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710
Practice Address - Country:US
Practice Address - Phone:330-453-3309
Practice Address - Fax:330-363-7413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2430622Medicaid
OH2430622Medicaid