Individual
JOHN NIRMALNATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2981 W 4TH ST, ONTARIO, OH 44906-1267
(419) 462-4561
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455
(419) 462-4561
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3506759
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000121141
ANTHEM
OH
05
—
0193311
—
OH
Enumeration date
11/27/2007
Last updated
01/06/2021
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