Organization
EMERGENCY MEDICINE PHYSICIANS OF LAKE MEDINA, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C PACKO MD (PRESIDENT)
(330) 493-4443
Entity
Organization
Contact information
Practice address
3780 MEDINA RD, MEDINA, OH 44256-9311
(877) 504-7849
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-4443
(330) 493-8677
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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