Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

NPI 1174308951

Individual provider · NPI 1174308951 Deactivated

This NPI was deactivated on September 6, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1174308951 is listed in the national NPI registry. Works from 2 locations.

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Practice location Incomplete address

The federal record is missing the street or ZIP for this provider.

No coordinates on file. Search this address in Google Maps

Additional practice locations (1)

  • 4368 Fishcreek Rd, Stow, OH 44224-2808 — (330) 673-8238

Specialties & licences

Record details

NPI number1174308951
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—