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Organization
PROMEDICA CENTRAL PHYSICIANS
Active
Organization
PROMEDICA CENTRAL PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA WINES (DIRECTOR, CREDENTIALING)
(567) 585-0422
Entity
Organization
Contact information
Practice address
100 MADISON AVE, MSC-S38805, TOLEDO, OH 43604-1531
(567) 585-1964
Mailing address
100 MADISON AVE, MSC-S38805, TOLEDO, OH 43604-1531
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
MI
207Q00000X
Family Medicine Physician
Primary
—
OH
207R00000X
Internal Medicine Physician
—
OH
207RC0000X
Cardiovascular Disease Physician
—
OH
207RP1001X
Pulmonary Disease Physician
—
MI
207RP1001X
Pulmonary Disease Physician
—
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
MI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
OH
207V00000X
Obstetrics & Gynecology Physician
—
OH
207W00000X
Ophthalmology Physician
—
MI
207Y00000X
Otolaryngology Physician
—
OH
208600000X
Surgery Physician
—
OH
2086S0129X
Vascular Surgery Physician
—
MI
363A00000X
Physician Assistant
—
OH
363L00000X
Nurse Practitioner
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0999273
—
OH
01
—
CI3157
RRMC
OH
Enumeration date
03/23/2006
Last updated
10/04/2023
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