| Constantine V. Economous M.d. Llc | |
|
2370 Southeast Blvd Salem OH 44460-3418 | |
| (330) 332-9961 | |
| (330) 337-3282 |
| Full Name | Constantine V. Economous M.d. Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2370 Southeast Blvd, Salem, Ohio |
| Authorized Official Name and Position | Constantine V Economous (PRESIDENT) |
| Authorized Official Contact | 3303329961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Constantine V. Economous M.d. Llc 2370 Southeast Blvd Salem OH 44460-3418 Ph: (330) 332-9961 | Constantine V. Economous M.d. Llc 2370 Southeast Blvd Salem OH 44460-3418 Ph: (330) 332-9961 |
| NPI Number | 1659110898 |
|---|---|
| Provider Enumeration Date | 05/20/2024 |
| Last Update Date | 05/20/2024 |
| Medicare PECOS PAC ID | 0648701813 |
|---|---|
| Medicare Enrollment ID | O20240930002511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659110898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Constantine V Economous |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396850269 PECOS PAC ID: 4082746888 Enrollment ID: I20100714000440 |
| Provider Name | Victoria Mohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578081873 PECOS PAC ID: 4587938642 Enrollment ID: I20170928000530 |
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