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Organization
SOUTHWEST GENERAL MEDICAL GROUP, INC.
Active
Organization
SOUTHWEST GENERAL MEDICAL GROUP, INC.
Active
Parent organization
SOUTHWEST GENERAL MEDICAL GROUP
Other names
Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST GENERAL MEDICAL GROUP
Authorized official
HEATHER WAGNER (EXECUTIVE DIRECTOR)
(440) 816-4906
Entity
Organization
Contact information
Practice address
4065 CENTER RD., #210, CLEVELAND, OH 44212
(330) 558-0050
Mailing address
PO BOX 638269, CINCINNATI, OH 45263-8269
(330) 558-0070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2238206
—
OH
Enumeration date
01/10/2007
Last updated
02/28/2019
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