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Organization

SUPERIOR MED LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TOM JEVAS (PRACTICE ADMINISTRATOR)
(740) 435-2404
Entity
Organization

Contact information

Practice address
10095 BRICK CHURCH RD, CAMBRIDGE, OH 43725-8550
(740) 435-4022
(740) 435-4028
Mailing address
1251 CLARK ST, CAMBRIDGE, OH 43725-9612
(740) 439-0733
(740) 439-8996

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0915013
OH
Enumeration date
05/16/2006
Last updated
12/29/2020
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