Organization
PARTNERS PHYSICIAN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH BRAMAN MD (CHIEF MEDICAL OFFICER, PPG)
(330) 665-8302
Entity
Organization
Contact information
Practice address
225 ELYRIA ST, LODI, OH 44254-1031
(330) 344-3583
Mailing address
225 ELYRIA ST, LODI, OH 44254-1031
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
OH
207V00000X
Obstetrics & Gynecology Physician
—
OH
208600000X
Surgery Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
06/05/2006
Last updated
02/13/2014
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