Organization
BRUNSWICK INTERNAL MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIE JOAN MODIE CCS (MEDICAL BILLER)
(330) 225-7733
Entity
Organization
Contact information
Practice address
3724 CENTER RD, SUITE 102, BRUNSWICK, OH 44212-4439
(330) 225-7733
(330) 220-0902
Mailing address
3724 CENTER RD, SUITE 102, BRUNSWICK, OH 44212-4439
(330) 225-7733
(330) 220-0902
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0956292
—
OH
Enumeration date
03/10/2008
Last updated
11/02/2011
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