Organization
PROMEDICA CENTRAL PHYSICIANS LLC
Active
Other names
ProMedica Children's Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN KNUEVEN (CREDENTIALING SUPERVISOR)
(567) 585-1969
Entity
Organization
Contact information
Practice address
1912 HAYES AVE, SANDUSKY, OH 44870-4736
(419) 557-6767
(419) 557-6783
Mailing address
1912 HAYES AVE, SANDUSKY, OH 44870-4736
(419) 557-6767
(419) 557-6783
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
—
OH
2080P0214X
Pediatric Pulmonology Physician
Primary
—
OH
Other
Enumeration date
12/11/2012
Last updated
02/05/2021
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