Organization
GREAT LAKES EMERGENCY PHYSICIANS MEDICAL GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN PETER MARON MD (MD)
(925) 225-5837
Entity
Organization
Contact information
Practice address
7531 S STONY ISLAND AVE, CHICAGO, IL 60649-3954
(773) 947-7500
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(844) 474-4019
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
12/11/2019
Last updated
11/30/2023
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