Organization
MAHONING VALLEY WOUND CARE, INC.
Active
Other names
FELIX A. PESA, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FELIX A PESA (OWNER)
(330) 480-2078
Entity
Organization
Contact information
Practice address
540 PARMALEE AVE, SUITE 610, YOUNGSTOWN, OH 44510-1716
(330) 480-2078
Mailing address
540 PARMALEE AVE, SUITE 610, YOUNGSTOWN, OH 44510-1716
(330) 480-2078
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
34025917
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000291311
ANTHEM
OH
05
—
0118938
—
OH
01
—
341107457027
CARESOURCE
OH
01
—
P00199613
MEDICARE/RR
OH
Enumeration date
11/21/2007
Last updated
01/26/2012
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