Organization
GASTROENTEROLOGY SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL M VAN NESS MD (PRESIDENT)
(330) 455-5011
Entity
Organization
Contact information
Practice address
2726 FULTON DR NW, CANTON, OH 44718-3506
(330) 455-5011
(330) 588-7127
Mailing address
2726 FULTON DR NW, CANTON, OH 44718-3506
(330) 455-5011
(330) 588-7127
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0975888
—
OH
01
—
7306060
AETNA
OH
01
—
C9333
MEDICARE RAILROAD
OH
Enumeration date
11/15/2005
Last updated
08/22/2020
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