Provider Demographics
NPI:1972795243
Name:LIWANAG ASUNCION M.D., INC
Entity type:Organization
Organization Name:LIWANAG ASUNCION M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIWANAG
Authorized Official - Middle Name:
Authorized Official - Last Name:ASUNCION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-288-1216
Mailing Address - Street 1:860 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:860 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6542
Practice Address - Country:US
Practice Address - Phone:440-288-1216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIWANAG ASUNCION M.D., INC 1515 KANSAS AVE LORAIN OH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-10
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2072911Medicaid
OH2072911Medicaid