Individual
JOHN P IMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5700 MONROE ST UNIT 111, SYLVANIA, OH 43560-2779
(567) 585-0005
(567) 585-0007
Mailing address
410 BIRCHARD AVE, FREMONT, OH 43420-2967
(419) 334-8943
(419) 334-8619
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35064477
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000277395
AZNTHEM
OH
01
—
04213
PARAMOUNT
OH
01
—
080191952
RRMC
OH
05
—
0992010
—
OH
01
—
15-70029
UHC
OH
01
—
4553666
AETNA
OH
Enumeration date
08/12/2005
Last updated
11/03/2023
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