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Organization
PROMEDICA MULTI SPECIALTY PHYSICIANS
Active
Organization
PROMEDICA MULTI SPECIALTY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRAINE MCCUNE (CREDENTIALING SPECIALIST)
(567) 585-1964
Entity
Organization
Contact information
Practice address
100 MADISON AVE, MSC-S38805, TOLEDO, OH 43604-1531
(567) 585-1964
(419) 824-7359
Mailing address
100 MADISON AVE, MSC-S38805, TOLEDO, OH 43604-1531
(567) 585-1964
(419) 824-7359
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
—
OH
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207RI0200X
Infectious Disease Physician
—
NULL
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
NULL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
OH
2086S0129X
Vascular Surgery Physician
—
NULL
2086S0129X
Vascular Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065185
—
OH
Enumeration date
05/15/2012
Last updated
12/16/2025
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