Berea Family Medicine, INC

NPI #1629190921 in Berea, Ohio

Provider Information

NPI Number: 1629190921
Entity Type: Organization
Organization Name: Berea Family Medicine, INC
Primary Specialty: Family Medicine
Enumeration Date: Apr 6, 2007
Last Updated: Oct 20, 2010

Practice Location

Address: 853 W BAGLEY RD
City: Berea
State: Ohio
ZIP Code: 44017-2903
Phone: (440) 234-0502

Authorized Official

Name: MARY ELLEN WIGGENHORN, LPN
Title: PRACTICE MANAGER
Phone: (440) 234-0502

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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