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Organization
MORENCI MEDICAL ASSOC, PC
Active
Organization
MORENCI MEDICAL ASSOC, PC
Active
Parent organization
MORENCI MEDICAL ASSOC, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MORENCI MEDICAL ASSOC, PC
Authorized official
DR. SHIVAPRASAS K SHETTY MD (PRESIDENT)
(419) 335-2811
Entity
Organization
Contact information
Practice address
137 S FULTON ST, WAUSEON, OH 43567-1351
(419) 335-2811
(419) 335-3388
Mailing address
137 S FULTON ST, WAUSEON, OH 43567-1351
(419) 335-2811
(419) 335-3388
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-06-8087S
OH
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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