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Contact Information

OTHELLO R REPUYAN MD
4188 HOLIDAY ST NW
CANTON, OH44718
 Phone: 330-492-4277
 Fax: 330-492-6973
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for OTHELLO R REPUYAN MD

NPI Number 1437254398
LBN Legal business name OTHELLO R REPUYAN MD
Authorized official OTHELLO REPUYAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/14/2006
Last updated 06/17/2008 - About 18 years ago
Identifiers
OH Medicaid 2651750
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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