Basic Information
| Provider Information | |||||||||
| NPI: | 1689706996 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARREN | ||||||||
| FirstName: | NORMAN | ||||||||
| MiddleName: | MICKEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6576 CULPEPPER ST NW | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447184104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304989747 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7337 CARITAS CIR NW | ||||||||
| Address2: | |||||||||
| City: | MASSILLON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446469118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308306110 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2007 | ||||||||
| LastUpdateDate: | 01/31/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 44123 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.