Basic Information
| Provider Information | |||||||||
| NPI: | 1255549036 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARBERTON INFECTIOUS DISEASES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 5TH ST NE STE 14 | ||||||||
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| City: | BARBERTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442033017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306154158 | ||||||||
| FaxNumber: | 3306154157 | ||||||||
| Practice Location | |||||||||
| Address1: | 1) 201 5TH ST NE STE 14, 2) BARBERTON CITIZENS HOSPITAL | ||||||||
| Address2: | 3) REGENCY HOSPITAL OF AKRON | ||||||||
| City: | BARBERTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442033017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306154158 | ||||||||
| FaxNumber: | 3306154157 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MOYENUDDIN | ||||||||
| AuthorizedOfficialFirstName: | MUNSHI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3306154158 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 01394369 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.