# BRUNSWICK INTERNAL MEDICINE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376713925
- **Authorized official:** MRS. MARIE JOAN MODIE CCS (MEDICAL BILLER)
- **Authorized official phone:** (330) 225-7733

## Contact information

- **Practice address:** 3724 CENTER RD, SUITE 102, BRUNSWICK, OH 44212-4439
- **Practice address phone:** (330) 225-7733
- **Practice address fax:** (330) 220-0902
- **Mailing address:** 3724 CENTER RD, SUITE 102, BRUNSWICK, OH 44212-4439
- **Mailing address phone:** (330) 225-7733
- **Mailing address fax:** (330) 220-0902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 03/10/2008
- **Last updated:** 11/02/2011