Promedica West Physicians, Llc

NPI 1003943010 - Internal Medicine - 207R00000X

NPI Details
NPI 1003943010
Enumeration Date 02/27/2007
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KIMBERLY KIMBERLY
Position CREDENTIALING SUPERVISOR
Phone (419) 784-2776
Fax (419) 782-6899
Practice Location
1250 RALSTON AVE
SUITE 202
DEFIANCE OH, 43512-5311, US
Phone (419) 784-2776
Fax (419) 782-6899
Business Location
1250 RALSTON AVE
SUITE 202
DEFIANCE OH, 43512-5311, US
Phone (419) 784-2776
Fax (419) 782-6899
Toxanomy
Taxonomy Code 207R00000X
License State Ohio
License Number =========
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According to our database, Promedica West Physicians, Llc NPI is 1003943010, taxonomy code is 207R00000X and license number is =========, license state is located at Ohio. Promedica West Physicians, Llc physically located at 1250 Ralston Ave, Defiance OH, 43512-5311. NPI Number 1033115704 has the healthcare provider type.

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1003943010 NPI number is provided on an as is basis without warranty of any kind. 1003943010 is maintained by the National Plan & Provider Enumeration System. The contents of Promedica West Physicians, Llc are for informational purposes only.