Your Direct Md | |
658 W Market St Ste 106 Lima OH 45801-5602 | |
(567) 970-3565 | |
Not Available |
Full Name | Your Direct Md |
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Speciality | Internal Medicine |
Location | 658 W Market St Ste 106, Lima, Ohio |
Authorized Official Name and Position | Nonso Ezema (MEDICAL DIRECTOR) |
Authorized Official Contact | 7089413516 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Your Direct Md 658 W Market St Ste 106 Lima OH 45801-5602 Ph: (567) 970-3565 | Your Direct Md 658 W Market St Ste 106 Lima OH 45801-5602 Ph: (567) 970-3565 |
NPI Number | 1124845037 |
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Provider Enumeration Date | 09/23/2024 |
Last Update Date | 09/23/2024 |
Medicare PECOS PAC ID | 9335672872 |
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Medicare Enrollment ID | O20241023001064 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124845037 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Nonso Ezema |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1588075626 PECOS PAC ID: 9537438080 Enrollment ID: I20170627001884 |
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