Camponovo, Ernest John
Camponovo, Ernest John is an individual health care provider with primary practice located at 3700 Park East Drive Suite 450, Beachwood OH 44122-4305. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Camponovo, Ernest John can be contacted via phone (855) 292-1401.Contact Information
Primary practice address
3700 Park East Drive Suite 450
Beachwood OH 44122-4305
Phone: (855) 292-1401
Fax: (866) 393-8340
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | MD042369L | Pennsylvania |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD042369L | Pennsylvania |
Profile Details
NPI number | 1588661904 |
---|---|
LBN Legal business name | Camponovo, Ernest John |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 30th, 2005 |
Last updated | May 24th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1588661904 | NPPES |
Michigan | MEDICAID | 1588661904 | |
Michigan | MEDICAID | 1588661904 | |
Michigan | MEDICAID | 0012389070048 | |
Michigan | MEDICAID | 003566900 | |
Michigan | MEDICAID | 7100356790 | |
Michigan | MEDICAID | 057342600 | |
Michigan | MEDICAID | 470001500 | |
Michigan | Other | G88056 |
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