Organization
RIDGEPARK MEDICAL ASSOCIATES INC
Active
Other names
Rockside Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES R KOEPKE MD (PRESIDENT)
(216) 749-8276
Entity
Organization
Contact information
Practice address
1440 ROCKSIDE RD STE 202, PARMA, OH 44134-2749
(216) 749-8276
(216) 749-8240
Mailing address
1440 ROCKSIDE RD STE 202, PARMA, OH 44134-2749
(216) 749-8276
(216) 749-8240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
NP09205
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2005145
—
OH
Enumeration date
02/22/2006
Last updated
05/10/2018
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