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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
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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