Organization
MARYSVILLE EMERGENCY PHYSICIANS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM A COLE JR. MD (CEO)
(800) 726-3627
Entity
Organization
Contact information
Practice address
500 LONDON AVE, MARYSVILLE, OH 43040-5512
(937) 644-6115
(937) 578-2812
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1402124
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000315461
BC/BC GRP PROVIDER NUMBER
OH
05
—
2452162
—
OH
01
—
C37351
HUMAMA GROUP PROVIDER #
OH
Enumeration date
08/02/2005
Last updated
06/27/2011
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