Provider Demographics
NPI:1982604013
Name:MASEELALL, ERWIN A (MD)
Entity Type:Individual
Prefix:
First Name:ERWIN
Middle Name:A
Last Name:MASEELALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ARCH ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1429
Mailing Address - Country:US
Mailing Address - Phone:330-376-1046
Mailing Address - Fax:330-376-0130
Practice Address - Street 1:75 ARCH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1429
Practice Address - Country:US
Practice Address - Phone:330-376-1046
Practice Address - Fax:330-376-0130
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35039918M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0383464Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH0383464Medicaid