Organization
PROMEDICA CENTRAL PHYSICIANS LLC
Active
Other names
Bay Park Surgical
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L DYWER (CREDENTIALING SUPERVISOR)
(419) 824-7334
Entity
Organization
Contact information
Practice address
2751 BAY PARK DR, SUITE 202, OREGON, OH 43616-4921
(419) 690-7550
(419) 697-7919
Mailing address
2751 BAY PARK DR, SUITE 202, OREGON, OH 43616-4921
(419) 690-7550
(419) 697-7919
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
OH
208C00000X
Colon & Rectal Surgery Physician
—
OH
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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