# BARBARA M MODIC MD INC

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

## Provider details

- **NPI number:** 1487968970
- **Authorized official:** DR. BARBARA MARIE MODIC M.D. (OWNER)
- **Authorized official phone:** (330) 792-2577

## Contact information

- **Practice address:** 25 N CANFIELD NILES RD, SUITE110, AUSTINTOWN, OH 44515-2328
- **Practice address phone:** (330) 792-2577
- **Practice address fax:** (330) 792-3199
- **Mailing address:** 25 N CANFIELD NILES RD, SUITE110, AUSTINTOWN, OH 44515-2328
- **Mailing address phone:** (330) 792-2577
- **Mailing address fax:** (330) 792-3199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 35055600 | OH | Yes |

## Other

- **Enumeration date:** 07/27/2010
- **Last updated:** 09/07/2010