Provider Demographics
NPI:1730995721
Name:AZIMUTH MEDICAL LLC
Entity type:Organization
Organization Name:AZIMUTH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALISTS
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-478-1919
Mailing Address - Street 1:1701 MENTOR AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-1459
Mailing Address - Country:US
Mailing Address - Phone:440-364-7590
Mailing Address - Fax:
Practice Address - Street 1:1701 MENTOR AVE STE 10
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1459
Practice Address - Country:US
Practice Address - Phone:440-364-7590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty