Organization
CANTON INTERNAL MEDICINE ASSOCIATES INCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY LYNN DIEHL (INSURANCE CLAIMS PROCESSOR)
(330) 833-5692
Entity
Organization
Contact information
Practice address
4076 HOLIDAY ST NW, CANTON, OH 44718
(330) 492-3738
(330) 492-5640
Mailing address
4076 HOLIDAY ST NW, CANTON, OH 44718
(330) 492-3738
(330) 492-5640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OH35060119
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0792898
—
OH
Enumeration date
06/09/2006
Last updated
08/22/2020
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