Organization
WARREN FAMILY MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAREEDAH ZAKIYYAH GOODWIN M.D. (PRESIDENT)
(330) 856-7702
Entity
Organization
Contact information
Practice address
8700 E MARKET ST, SUITE 4, WARREN, OH 44484-2340
(330) 856-7702
Mailing address
8700 E MARKET ST, SUITE 4, WARREN, OH 44484-2340
(330) 856-7702
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
85291
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2985328
—
OH
Enumeration date
10/22/2007
Last updated
01/12/2011
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