OTHELLO R REPUYAN MD (NPI# 1437254398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437254398 |
| Entity Type | Organization |
| Organization Name | OTHELLO R REPUYAN MD |
| Other Organization Name | MERIDIAN PEDIATRICS OF CANTON LLC |
| Practice Address |
4188 Holiday St Nw Canton OH 44718 |
| Mailing Address |
Po Box 80690 Canton OH 44708 |
| Practice Telephone | 3304924277 |
| Practice Fax Number | 3304926973 |
| Mailing Telephone | 3308335530 |
| Mailing Fax Number | 3308336085 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | OTHELLO R REPUYAN (PRESIDENT) |
| Authorized Official Telephone | 3304924277 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2651750 | 05 |
| Other Name | Type Code |
|---|---|
| Meridian Pediatrics of Canton LLC | Doing Business As Name - Organization |
| Street Address |
4188 HOLIDAY ST NW |
| City | CANTON |
| State | OH |
| Zip Code | 44718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639658057 | Christine Lynn Mccrone | Psychologist | 4450 Belden Village St Nw Ste 701, Canton, OH 44718 | 2018-08-07 |
| 1295252500 | Dora C Holliday | Student in an Organized Health Care Education/Training Program | 4641 Fulton Dr N.w., Canton, OH 44718 | 2017-08-28 |
| 1770035487 | A B A Let's Play, Inc. | Community/Behavioral Health | 6304 Shipslanding Ave Nw, Canton, OH 44718 | 2016-10-28 |
| 1457710139 | Aria Lg Counseling and Wellness Center, LLC | Clinic/Center | 5262 Fulton Road Nw, Canton, OH 44718 | 2016-02-23 |
| 1457722365 | Melinda R Bond | Nurse Practitioner | 4105 Holiday Street Nw, Canton, OH 44718 | 2015-10-19 |
| 1164804860 | Ashley Marie Whetsell | Dentist | 4550 Belden Village Street Nw, Canton, OH 44718 | 2015-06-18 |
| 1346643749 | Emil D. Poporad, Dds | Dentist | 4124 Fulton Rd. N.w., Suite 102, Canton, OH 44718 | 2014-09-30 |
| 1699198390 | Lauri Sanders | Social Worker | 5860 Fulton Dr Nw, Canton, OH 44718 | 2014-01-31 |
| 1376893768 | Courteney R Briceland | Social Worker | 4641 Fulton Rd. Nw, Canton, OH 44718 | 2012-09-13 |
| 1982953220 | Lyudmyla Z Rockaway | Marriage & Family Therapist | 4895 Dressler Road Nw, Ste A, Canton, OH 44718 | 2012-08-31 |
| Find all providers in zip 44718 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801264098 | Dhanalakshmi Senniappan | Pediatrics | Henry Ford Canton Medical Center, 6100 N Haggerty Rd, Canton, MI 48187-2169 | 2015-09-04 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1194037150 | Pediatric Center of Canton, LLC | Pediatrics | 1445 Harrison Ave. Nw, Suite 300 & 306, Canton, OH 44708 | 2010-07-07 |
| 1194046318 | Megan Ann Olson | Pediatrics | 1051 North Canton Rd, Canton, MI 48187-5097 | 2010-06-22 |
| 1992026140 | Jordan H Weitzner | Pediatrics | 2020 Cumming Hwy Ste 102, Canton, GA 30115-8071 | 2010-06-22 |
| 1639407679 | Augusto Rafael Martinez | Pediatrics | 1208 Davenport Ave, Canton, MA 02021-1012 | 2009-12-03 |
| 1295989002 | E. A. Malacaman M. D. LLC | Pediatrics | 3120 Parkway St Nw Ste C, Canton, OH 44708 | 2008-11-06 |
| 1922261106 | Jonathan A. Cheek, M.d. | Pediatrics | 134 Riverstone Ter, Suite 103, Canton, GA 30114-1706 | 2008-07-08 |
| 1598923294 | Hayley Griffin Teich | Pediatrics | 49650 Cherry Hill Rd Suite 210, Canton, MI 48187-1920 | 2008-05-29 |
| 1699832519 | G A Carmichael Family Health Center Inc | Pediatrics | 644 Finney Road, Canton, MS 39046 | 2007-01-02 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.