Promedica Genito-Urinary Surgeons LLC

NPI #1477980753 in Fremont, Ohio

Provider Information

NPI Number: 1477980753
Entity Type: Organization
Organization Name: Promedica Genito-Urinary Surgeons LLC
Primary Specialty: Urology
Enumeration Date: Oct 2, 2013
Last Updated: Oct 2, 2013

Practice Location

Address: 605 3RD AVE STE A
Address 2: SUITE B
City: Fremont
State: Ohio
ZIP Code: 43420-3269
Phone: (419) 332-7221

Authorized Official

Name: AMY L DWYER
Title: CREDENTIALING SUPERVISOR
Phone: (419) 824-7334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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