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Organization

NORTH COAST ORTHOPEDIC SURGERY INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN M BONDRA D.O. (PRESIDENT)
(419) 355-9800
Entity
Organization

Contact information

Practice address
629 BARTSON RD, FREMONT, OH 43420-9672
(419) 355-9800
Mailing address
PO BOX 546, FREMONT, OH 43420-0546
(419) 355-9800

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1187880001
MEDICARE DME MAC B
OH
05
2203083
OH
Enumeration date
02/22/2007
Last updated
08/18/2011
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