Organization
INTERNAL MEDICINE OF SPRINGFIELD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOICHI CHARLEY IMAMURA MD (PRESIDENT)
(939) 323-8804
Entity
Organization
Contact information
Practice address
1835 E HIGH ST, SPRINGFIELD, OH 45505-5210
(937) 323-8804
(888) 922-5090
Mailing address
1835 E HIGH ST, SPRINGFIELD, OH 45505-5210
(937) 323-8804
(888) 922-5090
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35070875
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000035503
ANTHEM
OH
01
—
0403252
UHC
OH
01
—
101046
BLACK LUNG
OH
01
—
110182531
RR MEDICARE
OH
05
—
2025267
—
OH
01
—
34187577027
CARESOURCE
OH
01
—
56969067500
WORKERS COMP
OH
01
—
569690675009
MEDICAL MUTUAL
OH
01
—
706669
AETNA
OH
Enumeration date
01/28/2008
Last updated
09/19/2011
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