Provider Demographics
NPI:1255549036
Name:BARBERTON INFECTIOUS DISEASES, INC
Entity type:Organization
Organization Name:BARBERTON INFECTIOUS DISEASES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUNSHI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYENUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-615-4158
Mailing Address - Street 1:201 5TH ST NE STE 14
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3017
Mailing Address - Country:US
Mailing Address - Phone:330-615-4158
Mailing Address - Fax:330-615-4157
Practice Address - Street 1:1) 201 5TH ST NE STE 14, 2) BARBERTON CITIZENS HOSPITAL
Practice Address - Street 2:3) REGENCY HOSPITAL OF AKRON
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3017
Practice Address - Country:US
Practice Address - Phone:330-615-4158
Practice Address - Fax:330-615-4157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01394369207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA9336331Medicare ID - Type Unspecified