Promedica Genito-Urinary Surgeons LLC

NPI #1477990893 in Archbold, Ohio

Provider Information

NPI Number: 1477990893
Entity Type: Organization
Organization Name: Promedica Genito-Urinary Surgeons LLC
Primary Specialty: Urology
Enumeration Date: May 24, 2013
Last Updated: May 24, 2013

Practice Location

Address: 121 WESTFIELD DR
City: Archbold
State: Ohio
ZIP Code: 43502-1056
Phone: (537) 444-4748

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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