Provider Demographics
NPI:1396105326
Name:ADVANCED CONCEPTS IN ENDOSCOPY
Entity type:Organization
Organization Name:ADVANCED CONCEPTS IN ENDOSCOPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-357-1474
Mailing Address - Street 1:6550 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-3462
Mailing Address - Country:US
Mailing Address - Phone:440-428-1944
Mailing Address - Fax:440-428-5847
Practice Address - Street 1:6550 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-3462
Practice Address - Country:US
Practice Address - Phone:440-428-1944
Practice Address - Fax:440-428-5847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty