| Internal Medicine Specialties Inc | |
|
920 W Market St Suite 210 Lima OH 45805-2773 | |
| (419) 229-3362 | |
| (419) 229-8258 |
| Full Name | Internal Medicine Specialties Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 920 W Market St, Lima, Ohio |
| Authorized Official Name and Position | Kemi Larne Azeez (PRESIDENT) |
| Authorized Official Contact | 4192293362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Specialties Inc 920 W Market St Suite 210 Lima OH 45805-2773 Ph: (419) 229-3362 | Internal Medicine Specialties Inc 920 W Market St Suite 210 Lima OH 45805-2773 Ph: (419) 229-3362 |
| NPI Number | 1376593822 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 12/10/2019 |
| Medicare PECOS PAC ID | 2961492681 |
|---|---|
| Medicare Enrollment ID | O20040514000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376593822 | NPI | - | NPPES |
| 2097494 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kemi Lanre Azeez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649231861 PECOS PAC ID: 4880689439 Enrollment ID: I20040518000804 |
| Provider Name | Olayinka Olatokunbo Omitowoju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164483327 PECOS PAC ID: 3779574975 Enrollment ID: I20040518000991 |
| Provider Name | Sasikala T Shanmugam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699736868 PECOS PAC ID: 0648261867 Enrollment ID: I20040518001098 |
| Provider Name | Jessica A Dailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023360864 PECOS PAC ID: 9335381789 Enrollment ID: I20130814000305 |
| Provider Name | Sarah J Nance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841967288 PECOS PAC ID: 9133509987 Enrollment ID: I20220711001585 |
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