| Stark County Physicians Llc | |
|
4143 Fulton Dr Nw Canton OH 44718-2819 | |
| (330) 244-8888 | |
| (330) 244-8850 |
| Full Name | Stark County Physicians Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4143 Fulton Dr Nw, Canton, Ohio |
| Authorized Official Name and Position | Steve K. Nam (PHYSICIAN MEMBER) |
| Authorized Official Contact | 3302448888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stark County Physicians Llc 4143 Fulton Dr Nw Canton OH 44718-2819 Ph: (330) 244-8888 | Stark County Physicians Llc 4143 Fulton Dr Nw Canton OH 44718-2819 Ph: (330) 244-8888 |
| NPI Number | 1154695815 |
|---|---|
| Provider Enumeration Date | 02/28/2012 |
| Last Update Date | 03/29/2023 |
| Medicare PECOS PAC ID | 5092075044 |
|---|---|
| Medicare Enrollment ID | O20180212002259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154695815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35044948 (Ohio) | Primary |
| Provider Name | Kun Woo Nam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851409189 PECOS PAC ID: 5890855126 Enrollment ID: I20100722000012 |
| Provider Name | Steve K Nam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174788061 PECOS PAC ID: 8820277429 Enrollment ID: I20110128000393 |
| Provider Name | Heather Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407396922 PECOS PAC ID: 3678858446 Enrollment ID: I20170316002227 |
| Provider Name | Laura Holliger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437605409 PECOS PAC ID: 8527317882 Enrollment ID: I20180820001481 |
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