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Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Other names
Metamora Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
KENYA DIXON (CREDENTIALING ASSISTANT)
(419) 824-7288
Entity
Organization
Contact information
Practice address
1990 COUNTY ROAD U, METAMORA, OH 43540-9717
(419) 644-4818
(419) 644-2589
Mailing address
1990 COUNTY ROAD U, METAMORA, OH 43540-9717
(419) 644-4818
(419) 644-2589
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4036950012
DMERC
OH
Enumeration date
02/17/2007
Last updated
11/29/2007
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