Promedica Central Physicians

NPI #1679844955 in Wauseon, Ohio

Provider Information

NPI Number: 1679844955
Entity Type: Organization
Organization Name: Promedica Central Physicians
Primary Specialty: Surgery
Enumeration Date: Jan 19, 2012
Last Updated: Jan 19, 2012

Practice Location

Address: 725 S SHOOP AVE
City: Wauseon
State: Ohio
ZIP Code: 43567-1702
Phone: (419) 330-2740

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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