Organization
MIDWEST CARDIOVASCULAR CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L BAHNSEN (CREDENTIALING SUPERVISOR)
(419) 824-7334
Entity
Organization
Contact information
Practice address
5855 MONROE ST, SYLVANIA, OH 43560-2269
(419) 824-7221
(419) 885-0064
Mailing address
5855 MONROE ST, SYLVANIA, OH 43560-2269
(419) 824-7221
(419) 885-0064
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2421605
—
OH
01
—
7663459
AETNA
OH
01
—
DA2406
RRMC
OH
Enumeration date
03/23/2006
Last updated
07/21/2022
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