# REVITALIZE MEDICAL GROUP, LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922443340
- **Authorized official:** DAVID L. SCOTT MD (EXECUTIVE LEADER)
- **Authorized official phone:** (330) 493-4443

## Contact information

- **Practice address:** 1 PARK WEST BLVD, SUITE 210, AKRON, OH 44320-4218
- **Practice address phone:** (330) 493-4443
- **Mailing address:** 4535 DRESSLER RD NW, CANTON, OH 44718-2545
- **Mailing address phone:** (330) 493-4443
- **Mailing address fax:** (330) 493-8677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |

## Other

- **Enumeration date:** 04/30/2013
- **Last updated:** 05/01/2013