| Broadview Heights Family Medicine, Inc | |
|
2001 E Royalton Rd Broadview Hts OH 44147-2811 | |
| (440) 717-6100 | |
| (440) 546-1382 |
| Full Name | Broadview Heights Family Medicine, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2001 E Royalton Rd, Broadview Hts, Ohio |
| Authorized Official Name and Position | Mark A Lang (OWNER) |
| Authorized Official Contact | 4407176100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadview Heights Family Medicine, Inc 2001 E Royalton Rd Broadview Hts OH 44147-2811 Ph: (440) 717-6100 | Broadview Heights Family Medicine, Inc 2001 E Royalton Rd Broadview Hts OH 44147-2811 Ph: (440) 717-6100 |
| NPI Number | 1063495224 |
|---|---|
| Provider Enumeration Date | 11/22/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2567420508 |
|---|---|
| Medicare Enrollment ID | O20041222000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063495224 | NPI | - | NPPES |
| 2234764 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Christine M King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821068560 PECOS PAC ID: 7618935545 Enrollment ID: I20041227000011 |
| Provider Name | Michelle Mackey-sawyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801891163 PECOS PAC ID: 5294870796 Enrollment ID: I20100309000350 |
| Provider Name | Melinda A Defilippo Szucs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083833925 PECOS PAC ID: 6507997244 Enrollment ID: I20100624000684 |
| Provider Name | Matthew C Andresen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295909539 PECOS PAC ID: 4981874005 Enrollment ID: I20110829000597 |
| Provider Name | Michelle Petrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336704972 PECOS PAC ID: 1759618705 Enrollment ID: I20190813003779 |
| Provider Name | Jennifer Gould |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912595901 PECOS PAC ID: 8628479664 Enrollment ID: I20210726003689 |
Uhmp Saridakis And Loyke Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 E Royalton Rd, Ste 202, Broadview Hts, OH 44147 Phone: 440-743-8130 Fax: 440-743-8131 |