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Organization

TRUMBULL MAHONING MEDICAL GROUP, INC.

Active
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Organization

TRUMBULL MAHONING MEDICAL GROUP, INC.

Active
Parent organization
TRUMBULL MAHONING MEDICAL GROUP, INC.
Other names
TMMG
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRUMBULL MAHONING MEDICAL GROUP, INC.
Authorized official
DR. MOURAD ROSTOM M.D. (PARTNER/EXECUTIVE)
(330) 372-8800
Entity
Organization

Contact information

Practice address
20 OHLTOWN RD, YOUNGSTOWN, OH 44515-2331
(330) 797-9705
(330) 270-5997
Mailing address
20 OHLTOWN RD, YOUNGSTOWN, OH 44515-2331
(330) 797-9705
(330) 270-5997

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000243183
ANTHEM BC/BS OHIO
OH
05
—
0468677
—
OH
01
—
1426141
HIGHMARK BC/BS PA
OH
Enumeration date
08/30/2007
Last updated
01/17/2014
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