| Trumbull Mahoning Medical Group, Inc. | |
|
2600 Elm Rd Ne Cortland OH 44410-9393 | |
| (330) 372-8800 | |
| (330) 372-8999 |
| Full Name | Trumbull Mahoning Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2600 Elm Rd Ne, Cortland, Ohio |
| Authorized Official Name and Position | Mourad Rostom (PRESIDENT/CEO) |
| Authorized Official Contact | 3303728820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trumbull Mahoning Medical Group, Inc. 2600 Elm Rd Ne Cortland OH 44410-9393 Ph: (330) 372-8800 | Trumbull Mahoning Medical Group, Inc. 2600 Elm Rd Ne Cortland OH 44410-9393 Ph: (330) 372-8800 |
| NPI Number | 1285642769 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 01/17/2014 |
| Medicare PECOS PAC ID | 3779537022 |
|---|---|
| Medicare Enrollment ID | O20050309000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285642769 | NPI | - | NPPES |
| 0468677 | Medicaid | OH | |
| 1426141 | Other | OH | HIGHMARK |
| 000000243183 | Other | OH | ANTHEM BC/BS OHIO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mary Ann Fontanarosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902824188 PECOS PAC ID: 6406800788 Enrollment ID: I20050309000753 |
| Provider Name | Dan Neil Olson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417981077 PECOS PAC ID: 4183678360 Enrollment ID: I20050310000339 |
| Provider Name | Sameh Ibrahi Youssef |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023042850 PECOS PAC ID: 4587618780 Enrollment ID: I20050310000460 |
| Provider Name | Ruth F Quarles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508892811 PECOS PAC ID: 0244284453 Enrollment ID: I20050310000508 |
| Provider Name | Allison Orndorff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508528175 PECOS PAC ID: 8628444338 Enrollment ID: I20221021000327 |
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Tmmg Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 Elm Rd Ne, Cortland, OH 44410 Phone: 330-372-8800 Fax: 330-372-8999 | |
Premier Care Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2642 State Route 5, Cortland, OH 44410 Phone: 330-841-5500 Fax: 330-884-6120 | |
Ohio North East Health Systems, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2642 State Route 5, Cortland, OH 44410 Phone: 330-841-5500 Fax: 330-884-6120 | |
Robert F Naples Do Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2249 Elm Road Extension, Cortland, OH 44410 Phone: 330-372-1608 Fax: 330-372-1013 |