Organization
FAMILY HEALTH CARE OF MARYSVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE J. WARREN M.D. (OWNER)
(937) 578-2860
Entity
Organization
Contact information
Practice address
681 LONDON AVE, MARYSVILLE, OH 43040-1599
(937) 642-2862
(937) 642-9862
Mailing address
200 BRADENTON AVE, DUBLIN, OH 43017-7515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-05-5046
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2581764
—
OH
Enumeration date
05/25/2006
Last updated
09/06/2007
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