Organization
DIGESTIVE WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHULAM N. MIR MD (MEDICAL DIRECTOR)
(330) 753-6643
Entity
Organization
Contact information
Practice address
3939 SOUTH CLEVELAND-MASSILLON ROAD, NORTON, OH 44203
(330) 237-1058
(330) 237-1059
Mailing address
3939 CLEVELAND MASSILLON RD, NORTON, OH 44203-5611
(330) 237-1058
(330) 237-1059
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3612341
MEDICARE PTAN
OH
Enumeration date
02/27/2007
Last updated
06/05/2008
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