Basic Information
| Provider Information | |||||||||
| NPI: | 1295900827 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACCESS MEDICAL GROUP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3389 | ||||||||
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| City: | WESTERVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430863389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8667274612 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 MCKINLEY PARK DR | ||||||||
| Address2: | MRI SUITE | ||||||||
| City: | MARION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433026399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8667274612 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2008 | ||||||||
| LastUpdateDate: | 05/22/2014 | ||||||||
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| AuthorizedOfficialLastName: | BEKKAM | ||||||||
| AuthorizedOfficialFirstName: | NAVEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8667274612 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35.088943 | OH | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.