| Justin P. Mikula, M.d., Inc. | |
|
1615 N River Rd Ne Suite 1 Warren OH 44483-2437 | |
| (330) 372-2333 | |
| (330) 373-1111 |
| Full Name | Justin P. Mikula, M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1615 N River Rd Ne, Warren, Ohio |
| Authorized Official Name and Position | Justin P Mikula (PRESIDENT) |
| Authorized Official Contact | 3303722333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Justin P. Mikula, M.d., Inc. 1615 N River Rd Ne Suite 1 Warren OH 44483-2437 Ph: (330) 372-2333 | Justin P. Mikula, M.d., Inc. 1615 N River Rd Ne Suite 1 Warren OH 44483-2437 Ph: (330) 372-2333 |
| NPI Number | 1750487542 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 01/31/2020 |
| Medicare PECOS PAC ID | 9436176195 |
|---|---|
| Medicare Enrollment ID | O20051101000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750487542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35-084818 (Ohio) | Primary |
| Provider Name | Justin P Mikula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508839614 PECOS PAC ID: 8426075185 Enrollment ID: I20051101000679 |
| Provider Name | Tiffany Lyn Victor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295046514 PECOS PAC ID: 6204068836 Enrollment ID: I20140415000622 |
| Provider Name | Vincent Edward Mikula |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851911655 PECOS PAC ID: 8325469356 Enrollment ID: I20200529002653 |
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