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Organization
PROMEDICA CENTRAL PHYSICIANS
Active
Organization
PROMEDICA CENTRAL PHYSICIANS
Active
Other names
ProMedica Physicians Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA R MARSHALL (CREDENTIALING SPECIALIST)
(567) 585-1997
Entity
Organization
Contact information
Practice address
1 SEAGATE, SUITE 800, TOLEDO, OH 43604
(567) 585-1997
(419) 824-7359
Mailing address
1 SEAGATE, SUITE 800, TOLEDO, OH 43604-1558
(567) 585-1997
(419) 824-7359
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
MI
152W00000X
Optometrist
—
OH
207W00000X
Ophthalmology Physician
Primary
—
MI
207W00000X
Ophthalmology Physician
—
OH
Other
Enumeration date
08/13/2014
Last updated
08/27/2018
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