Organization
UPPER SANDUSKY MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONSTANTINE K SOLACOFF MD (CORPORATION PRESIDENT)
(419) 294-2375
Entity
Organization
Contact information
Practice address
777 N SANDUSKY AVE, UPPER SANDUSKY, OH 43351-1075
(419) 294-2375
(419) 294-2412
Mailing address
777 N SANDUSKY AVE, UPPER SANDUSKY, OH 43351-1075
(419) 294-2375
(419) 294-2412
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0423652
—
OH
Enumeration date
07/14/2005
Last updated
07/21/2022
Update your record
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