Organization
HARTVILLE INTERNAL MEDICINE PA
Active
Parent organization
HARTVILLE INTERNAL MEDICINE PA
Other names
Minerva Medical Center
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
200 CAROLYN CT, MINERVA, OH 44657-8758
(330) 868-4184
(330) 488-2907
Mailing address
200 CAROLYN CT, MINERVA, OH 44657-8758
(330) 868-4184
(330) 488-2907
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000342549
ANTHEM
OH
05
—
2535742
—
OH
Enumeration date
11/03/2005
Last updated
05/02/2012
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