Organization
WILMINGTON SURGICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOY DAWN LEVERICH MD (PRESIDENT)
(937) 383-2401
Entity
Organization
Contact information
Practice address
691 KELLY DR, WILMINGTON, OH 45177-1471
(937) 383-2401
Mailing address
691 KELLY DR, WILMINGTON, OH 45177-1471
(937) 383-2401
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0324670
—
OH
01
—
CC9837
RR MEDICARE
OH
Enumeration date
10/12/2006
Last updated
10/19/2011
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