| |
7551 Fredle Drive Concord OH 44077 | |
(440) 357-1474 | |
(440) 357-1905 |
Full Name | |
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Speciality | Internal Medicine |
Location | 7551 Fredle Drive, Concord, Ohio |
Authorized Official Name and Position | Doris A Myers (OWNER / PHYSICIAN) |
Authorized Official Contact | 4403509595 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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7551 Fredle Drive Concord OH 44077 Ph: (440) 357-1474 | 7551 Fredle Drive Concord OH 44077 Ph: (440) 357-1474 |
NPI Number | 1083730782 |
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Provider Enumeration Date | 03/22/2007 |
Last Update Date | 07/22/2020 |
Medicare PECOS PAC ID | 1658565254 |
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Medicare Enrollment ID | O20101027001291 |
Identifier | Type | State | Issuer |
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1083730782 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | 34003594M (Ohio) | Primary |
Provider Name | Doris A Myers |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1598787319 PECOS PAC ID: 7719171321 Enrollment ID: I20101027001351 |