Basic Information
| Provider Information | |||||||||
| NPI: | 1457452930 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANTONY M GEORGE MD & ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28080 CHARDON RD STE 04 | ||||||||
| Address2: | |||||||||
| City: | WICKLIFFE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440923000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409442863 | ||||||||
| FaxNumber: | 4409442697 | ||||||||
| Practice Location | |||||||||
| Address1: | 28080 CHARDON RD STE 04 | ||||||||
| Address2: | |||||||||
| City: | WICKLIFFE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440923000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409442863 | ||||||||
| FaxNumber: | 4409442697 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GEORGE | ||||||||
| AuthorizedOfficialFirstName: | ANTONY | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRES/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4409442863 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-064060 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.