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Organization
SOUTHWEST GENERAL MEDICAL GROUP INC
Active
Organization
SOUTHWEST GENERAL MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER WAGNER (EXECUTIVE DIRECTOR)
(440) 816-4906
Entity
Organization
Contact information
Practice address
7255 OLD OAK BLVD STE C202, CLEVELAND, OH 44130-3300
(440) 816-5390
Mailing address
PO BOX 638269, CINCINNATI, OH 45263-0001
(440) 816-5390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2238144
—
OH
Enumeration date
08/30/2006
Last updated
09/18/2024
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