Canton Internal Medicine Associates Ince | |
4076 Holiday St Nw Canton OH 44718 | |
(330) 492-3738 | |
(330) 492-5640 |
Full Name | Canton Internal Medicine Associates Ince |
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Speciality | Internal Medicine |
Location | 4076 Holiday St Nw, Canton, Ohio |
Authorized Official Name and Position | Stacy Lynn Diehl (INSURANCE CLAIMS PROCESSOR) |
Authorized Official Contact | 3308335692 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Canton Internal Medicine Associates Ince 4076 Holiday St Nw Canton OH 44718 Ph: (330) 492-3738 | Canton Internal Medicine Associates Ince 4076 Holiday St Nw Canton OH 44718 Ph: (330) 492-3738 |
NPI Number | 1518908698 |
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Provider Enumeration Date | 06/09/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 5698670198 |
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Medicare Enrollment ID | O20100222000029 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518908698 | NPI | - | NPPES |
0792898 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | OH35060119 (Ohio) | Primary |
Provider Name | Eser Talug |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1255322913 PECOS PAC ID: 8224933726 Enrollment ID: I20040211000954 |
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