Organization
HARTVILLE INTERNAL MEDICINE PA
Active
Parent organization
HARTVILLE INTERNAL MEDICINE PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
HARTVILLE INTERNAL MEDICINE PA
Authorized official
AMIN YOUSSEF KHALIL M.D. (PRESIDENT)
(330) 877-9388
Entity
Organization
Contact information
Practice address
855 W MAPLE ST, SUITE 130, HARTVILLE, OH 44632-9668
(330) 877-9388
(330) 488-2907
Mailing address
855 W MAPLE ST, SUITE 130, HARTVILLE, OH 44632-9668
(330) 877-9388
(330) 488-2907
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213674
ANTHEM
OH
01
—
101425
BLACK LUNG
OH
05
—
2526476
—
OH
Enumeration date
11/07/2005
Last updated
05/02/2012
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