Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Other names
Toledo Peds'
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A GOVAN (CREDENTIALING SPECIALIST)
(419) 824-7221
Entity
Organization
Contact information
Practice address
3922 WOODLEY RD, SUITE 100, TOLEDO, OH 43606-1130
(419) 291-2121
(419) 479-6017
Mailing address
3922 WOODLEY RD, SUITE 100, TOLEDO, OH 43606-1130
(419) 291-2121
(419) 479-6017
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0999273
—
OH
01
—
5626412
AETNA
OH
01
—
CI3157
RRMC
OH
Enumeration date
02/20/2007
Last updated
07/21/2022
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