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Organization
WAKEMAN AREA FAMILY CARE CENTER
Active
Organization
WAKEMAN AREA FAMILY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA TANIGAWA (OFFICE MANAGER)
(440) 839-2226
Entity
Organization
Contact information
Practice address
24 HYDE ST, WAKEMAN, OH 44889-9301
(440) 839-2226
(440) 839-1339
Mailing address
24 HYDE ST, WAKEMAN, OH 44889-9301
(440) 839-2226
(440) 839-1339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35062083
OH
363A00000X
Physician Assistant
50000956
OH
363LF0000X
Family Nurse Practitioner
NP08465
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2158481
—
OH
Enumeration date
05/15/2006
Last updated
12/19/2007
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