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500 Portage Lakes Dr Suite B Akron OH 44319-2299 | |
| (330) 375-7055 | |
| (330) 375-7060 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 500 Portage Lakes Dr, Akron, Ohio |
| Authorized Official Name and Position | Gina Rood (SR IT SYSTEMS ANALYST) |
| Authorized Official Contact | 2343125193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1077 Gorge Blvd Akron OH 44310-2408 Ph: (234) 312-5873 | 500 Portage Lakes Dr Suite B Akron OH 44319-2299 Ph: (330) 375-7055 |
| NPI Number | 1275718850 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 07/25/2023 |
| Certification Date | 07/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275718850 | NPI | - | NPPES |
| 2788425 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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