Provider Demographics
NPI:1063146272
Name:MICHAEL R. MAGOLINE MD INC
Entity type:Organization
Organization Name:MICHAEL R. MAGOLINE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAGOLINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:234-236-7922
Mailing Address - Street 1:799 WHITE POND DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1189
Mailing Address - Country:US
Mailing Address - Phone:234-236-7922
Mailing Address - Fax:440-557-6450
Practice Address - Street 1:799 WHITE POND DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1189
Practice Address - Country:US
Practice Address - Phone:234-236-7922
Practice Address - Fax:440-557-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty