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93 West Exchange Street Akron OH 44308-1040 | |
| (330) 762-7248 | |
| (330) 762-0665 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 93 West Exchange Street, Akron, Ohio |
| Authorized Official Name and Position | Beverly J Dearth (DIRECTOR) |
| Authorized Official Contact | 3307627250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
93 West Exchange Street Akron OH 44308-1040 Ph: (330) 762-7248 | 93 West Exchange Street Akron OH 44308-1040 Ph: (330) 762-7248 |
| NPI Number | 1518025170 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518025170 | NPI | - | NPPES |
| 0586727 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1131 (Ohio) | Primary |
| 207Q00000X | Family Medicine | 35037421 (Ohio) | Primary |
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