Morenci Medical Assoc, PC

NPI #1962690735 in Wauseon, Ohio

Provider Information

NPI Number: 1962690735
Entity Type: Organization
Organization Name: Morenci Medical Assoc, PC
Subpart: Yes (part of a larger organization)
Parent Organization: MORENCI MEDICAL ASSOC, PC
Primary Specialty: Family Medicine
Enumeration Date: Oct 5, 2007
Last Updated: Oct 5, 2007

Practice Location

Address: 137 S FULTON ST
City: Wauseon
State: Ohio
ZIP Code: 43567-1351
Phone: (419) 335-2811

Authorized Official

Name: DR. SHIVAPRASAS K SHETTY, MD
Title: PRESIDENT
Phone: (419) 335-2811

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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