Provider Demographics
NPI:1104882307
Name:ALLIANCE OBSTETRICS INC
Entity type:Organization
Organization Name:ALLIANCE OBSTETRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:S
Authorized Official - Last Name:O'DEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-821-4869
Mailing Address - Street 1:270 E STATE ST
Mailing Address - Street 2:SUITE G100
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4300
Mailing Address - Country:US
Mailing Address - Phone:330-821-4869
Mailing Address - Fax:330-821-6358
Practice Address - Street 1:270 E STATE ST
Practice Address - Street 2:SUITE G100
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4300
Practice Address - Country:US
Practice Address - Phone:330-821-4869
Practice Address - Fax:330-821-6358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0518005Medicaid
OH0518005Medicaid
AL9261231Medicare PIN