Organization
MORENCI MEDICAL ASSOC, PC
Active
Parent organization
MORENCI MEDICAL ASSOC, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MORENCI MEDICAL ASSOC, PC
Authorized official
DR. SHIVAPRASAS K SHETTY MD (PRESIDENT)
(419) 335-2811
Entity
Organization
Contact information
Practice address
137 S FULTON ST, WAUSEON, OH 43567-1351
(419) 335-2811
(419) 335-3388
Mailing address
137 S FULTON ST, WAUSEON, OH 43567-1351
(419) 335-2811
(419) 335-3388
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-06-8087S
OH
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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