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Organization
MARYMOUNT PRIMARY CARE SERVICES, INC.
Active
Organization
MARYMOUNT PRIMARY CARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER P WALCHANOWICZ (PRACTICE MANAGER)
(440) 543-8855
Entity
Organization
Contact information
Practice address
6701 ROCKSIDE RD, SUITE 260, INDEPENDENCE, OH 44131-2358
(216) 369-2525
(216) 369-2531
Mailing address
6701 ROCKSIDE RD, SUITE 260, INDEPENDENCE, OH 44131-2358
(216) 369-2525
(216) 369-2531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
08/07/2007
Last updated
05/28/2008
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