Individual
DR. JEFFREY T PREM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
6046 WHIPPLE AVE NW STE 203, NORTH CANTON, OH 44720-7616
(330) 588-8900
(330) 588-8990
Mailing address
6046 WHIPPLE AVE NW STE 203, NORTH CANTON, OH 44720-7616
(330) 588-8900
(330) 588-8990
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35071936P
OH
2086S0129X
Vascular Surgery Physician
Primary
35071936P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2048484
—
OH
Enumeration date
11/10/2005
Last updated
04/09/2020
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