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Organization
PRIMARY CARE OF NORTHWEST OHIO, INC
Active
Organization
PRIMARY CARE OF NORTHWEST OHIO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MICHAEL MAURIC DO (PRESIDENT)
(419) 355-8070
Entity
Organization
Contact information
Practice address
605 3RD AVE, BLG B STE D, FREMONT, OH 43420-3269
(419) 355-8070
(419) 355-1109
Mailing address
605 3RD AVE, BLG B STE D, FREMONT, OH 43420-3269
(419) 355-8070
(419) 355-1109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2256473
—
OH
01
—
740142
BUCKEYE MEDICAID
OH
01
—
CH7959
RAILROAD MEDICARE
OH
01
—
R04778
SUMMACARE
OH
Enumeration date
12/12/2007
Last updated
01/28/2014
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