Fall, Douglas
Fall, Douglas is an individual health care provider with primary practice located at 4001 Carrick Dr Ste 160 , Medina OH 44256-5392. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Fall, Douglas can be contacted via phone (330) 723-7005.Contact Information
Primary practice address
4001 Carrick Dr Ste 160
Medina OH 44256-5392
Phone: (330) 723-7005
Fax: (330) 723-4854
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 35073387F | Ohio |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35-073387 | Ohio |
Profile Details
| NPI number | 1205883899 |
|---|---|
| LBN Legal business name | Fall, Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 28th, 2006 |
| Last updated | Jul 26th, 2011 - about 14 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 | 1205883899 | NPPES |
| Ohio | MEDICAID | 2315248 | |
| Ohio | Other | 942460636083 |
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