VITREO RETINAL CONSULTANTS, INC. (NPI# 1750347662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750347662 |
| Entity Type | Organization |
| Organization Name | VITREO RETINAL CONSULTANTS, INC. |
| Practice Address |
4676 Douglas Cir Nw Canton OH 44718-3619 |
| Practice Telephone | 3304941116 |
| Practice Fax Number | 3304940276 |
| Mailing Telephone | 3304941116 |
| Mailing Fax Number | 3304940276 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-12-03 |
| Authorized Official Name | MARK A. GERSMAN (VICE PRESIDENT) |
| Authorized Official Telephone | 3304941116 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 6300115000 | 05 | |
| OH | 0693576 | 05 | |
| PA | 0015118480004 | 05 |
| Street Address |
4676 DOUGLAS CIR NW |
| City | CANTON |
| State | OH |
| Zip Code | 44718-3619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061876 | Joseph James Fammartino | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2005-05-31 |
| 1386932069 | Deepam Rusia | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2011-07-15 |
| 1316001720 | Sophia Ioannis Pachydaki | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2006-12-20 |
| 1215027115 | Stephen M Conti | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2006-10-13 |
| 1437151743 | Marcus Fawzy George Estafanous | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2005-06-01 |
| 1568464832 | Stephen Richard Kaufman | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2005-06-01 |
| 1205839552 | Mark Andrew Gersman | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2005-05-31 |
| 1639172984 | Robert Edward Wenz | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2005-05-31 |
| 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 | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609808146 | Nigel H. Timothy | Ophthalmology | 95 Washington Street, Suite 592, Village Shoppes, Canton, MA 02021 | 2006-07-07 |
| 1679515282 | Philip C Roholt | Ophthalmology | 5890 Mayfair Rd, Canton, OH 44720-1547 | 2006-06-11 |
| 1417923657 | Cameron Campbell Johnson | Ophthalmology | 201 Kimberly Way Ste 106, Canton, GA 30114-8009 | 2006-02-27 |
| 1699754606 | Arnold F Nothnagel | Ophthalmology | 4690 Munson St Nw, Canton, OH 44718-3636 | 2006-01-10 |
| 1356337448 | William Parker Marks Jr. | Ophthalmology | 125 Oakside Ct, Suite 102, Canton, GA 30114-2498 | 2005-09-23 |
| 1386643104 | Paul W Turgeon | Ophthalmology | 800 Mckinley Ave Nw, Canton, OH 44703-2463 | 2005-07-14 |
| 1104824614 | Dennis Z Weber | Ophthalmology | 8538 N Canton Center Rd, Canton, MI 48187-1310 | 2005-07-08 |
| 1528061876 | Joseph James Fammartino | Ophthalmology | 4676 Douglas Cir Nw, Canton, OH 44718-3619 | 2005-05-31 |
| 1588667752 | Keith Andrew Kobet | Ophthalmology | 7949 N Canton Center Rd, Canton, MI 48187-1533 | 2005-05-23 |
| 1861887473 | Karan Hiten Patel | Ophthalmology | 1051 N Canton Center Rd, Canton, MI 48187-5097 | 2015-03-31 |
| 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.