Individual
DR. JORGE L SIFUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
(419) 228-3335
Mailing address
951 COMMERCE PKWY STE 101, LIMA, OH 45804-4040
(419) 998-4575
(419) 998-4586
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35055919
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175871
ANTHEM
OH
01
—
050077131
RAILROAD MEDICARE
OH
05
—
0788876
—
OH
Enumeration date
06/12/2006
Last updated
02/13/2018
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