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Organization

SHELBY COUNTY SURGICAL ASSOC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHARON C MAURER (OFFICE MANAGER)
(937) 492-2094
Entity
Organization

Contact information

Practice address
915 WEST MICHIGAN STREET, SUITE 201, SIDNEY, OH 45365-2491
(937) 492-2094
(937) 492-1768
Mailing address
915 W MICHIGAN STREET, SUITE 201, SIDNEY, OH 45365-2491
(937) 492-2094
(937) 492-1768

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000026762
ANTHEM GROUP NUMBER
OH
05
0703555
OH
01
4480806
AETNA GROUP NUMBER
OH
01
C14899
TRAVLERS RR GROUP NUMBER
OH
Enumeration date
01/19/2007
Last updated
12/07/2011
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