Organization
OHIO PERMANENTE MEDICAL GROUP
Active
Other names
Kaiser Permanente
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG FAERBER (VP/CFO)
(216) 265-8844
Entity
Organization
Contact information
Practice address
4914 PORTAGE ST NW, NORTH CANTON, OH 44720-7249
(216) 265-8844
(216) 265-8894
Mailing address
12301 SNOW RD, PARMA, OH 44130-1002
(216) 265-8844
(216) 265-8894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
OH
207R00000X
Internal Medicine Physician
Primary
—
OH
208000000X
Pediatrics Physician
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0211372
—
OH
Enumeration date
09/20/2011
Last updated
09/20/2011
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