| Sam N Ghoubrial Md Inc | |
|
195 Wadsworth Rd. Suite 402 Wadsworth OH 44281 | |
| (330) 331-7207 | |
| (330) 331-7587 |
| Full Name | Sam N Ghoubrial Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 195 Wadsworth Rd., Wadsworth, Ohio |
| Authorized Official Name and Position | Crystal Pelfrey (OFFICE MANAGER) |
| Authorized Official Contact | 3303317207 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sam N Ghoubrial Md Inc 3535 Granger Rd Akron OH 44333-1538 Ph: (330) 331-7207 | Sam N Ghoubrial Md Inc 195 Wadsworth Rd. Suite 402 Wadsworth OH 44281 Ph: (330) 331-7207 |
| NPI Number | 1821170911 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 9234184276 |
|---|---|
| Medicare Enrollment ID | O20050314000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821170911 | NPI | - | NPPES |
| 2683298 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | 35067926 (Ohio) | Primary |
| Provider Name | Sam N Ghoubrial |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003892217 PECOS PAC ID: 1456316033 Enrollment ID: I20041123000306 |
| Provider Name | Charlene Moyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427034644 PECOS PAC ID: 9234184094 Enrollment ID: I20050315000679 |
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