Provider Demographics
NPI:1871719641
Name:DR. MICHAEL J. NAMEY, D.O., INC
Entity type:Organization
Organization Name:DR. MICHAEL J. NAMEY, D.O., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:NAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-293-2444
Mailing Address - Street 1:456 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44003-9602
Mailing Address - Country:US
Mailing Address - Phone:440-293-2444
Mailing Address - Fax:440-293-2445
Practice Address - Street 1:456 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:OH
Practice Address - Zip Code:44003-9602
Practice Address - Country:US
Practice Address - Phone:440-293-2444
Practice Address - Fax:440-293-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00343466208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTAX ID