Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 35-067137 | OH |
Y | 208800000X | Urologist | 35.067137B | OH |
NPI | 1447226337 |
---|---|
Provider Name | Raymond A Bologna |
First Address | Akron, OH 44302-1709 |
Second Address | Akron, OH 44302-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1841239274 | PARTNERS PHYSICIAN GROUP TYPE 2 NPI # (01) | OH |
2127782 | (05) | OH |
2551671 | PARTNERS PHYSICIAN GROUP MEDICAID GROUP # (01) | OH |
9338635 | PARTNERS PHYSICIAN GROUP MEDICARE GROUP # (01) | OH |
G86099 | (02) |