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Organization
WAYNE INTERNAL MEDICINE
Active
Organization
WAYNE INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSAMA MITRI MD (PRESIDENT)
(330) 262-1700
Entity
Organization
Contact information
Practice address
128 EAST MILLTOWN ROAD, SUITE 101, WOOSTER, OH 44691-6109
(330) 262-1700
(330) 345-8980
Mailing address
PO BOX 1206, WOOSTER, OH 44691-7083
(330) 262-1700
(330) 345-8980
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35077131
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000279626
ANTHEM
OH
Enumeration date
10/24/2007
Last updated
11/03/2007
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