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Organization
TRUMBULL MAHONING MEDICAL GROUP INC
Active
Organization
TRUMBULL MAHONING MEDICAL GROUP INC
Active
Parent organization
TRUMBULL MAHONING MEDICAL GROUP INC
Other names
TMMG Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRUMBULL MAHONING MEDICAL GROUP INC
Authorized official
MOURAD ROSTOM MD (PARTNER/EXECUTIVE)
(330) 372-8820
Entity
Organization
Contact information
Practice address
2600 ELM RD NE, CORTLAND, OH 44410-9393
(330) 372-8820
(330) 372-8999
Mailing address
2600 ELM ROAD NE, CORTLAND, OH 44410
(330) 372-8895
(330) 372-8999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000243183
ANTHEM
OH
05
—
0468677
—
OH
01
—
1426141
HIGHMARK OF PA
PA
Enumeration date
07/03/2008
Last updated
01/17/2014
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