Organization
GEAUGA MEDICAL THERAPY CENTER LLC
Active
Parent organization
FADUL HEALTH PARTNERS, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FADUL HEALTH PARTNERS, PLLC
Authorized official
DR. ZAID FADUL MD (CEO)
(855) 360-4673
Entity
Organization
Contact information
Practice address
13170 RAVENNA RD, SUITE 108, CHARDON, OH 44024-7025
(440) 409-7055
(440) 279-4009
Mailing address
125 W MCDOWELL RD, SUITE A, PHOENIX, AZ 85003-1223
(855) 360-4673
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
35.122879
OH
Other
Enumeration date
09/05/2015
Last updated
07/12/2016
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