Organization
NEURODEVELOPMENTAL CENTER OF NORTHWEST OHIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD IAN CAMERON M.D. (PRESIDENT PHYSICIAN)
(419) 874-8447
Entity
Organization
Contact information
Practice address
28442 E RIVER RD, SUITE 203, PERRYSBURG, OH 43551-2858
(419) 874-8447
(419) 874-8793
Mailing address
28442 E RIVER RD, SUITE 203, PERRYSBURG, OH 43551-2858
(419) 874-8447
(419) 874-8793
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35047115C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000132630
ANTHEM
OH
05
—
2868679
—
OH
01
—
293725208012
MEDICAL MUTUAL OF OHIO
OH
Enumeration date
01/30/2006
Last updated
10/11/2011
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