Provider Demographics
NPI:1346417987
Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS INC
Entity type:Organization
Organization Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SEDLMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-931-3081
Mailing Address - Street 1:28555 STARBRIGHT BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-4687
Mailing Address - Country:US
Mailing Address - Phone:419-931-3081
Mailing Address - Fax:419-931-3048
Practice Address - Street 1:28555 STARBRIGHT BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-4687
Practice Address - Country:US
Practice Address - Phone:419-931-3081
Practice Address - Fax:419-931-3048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9357163Medicare PIN