Provider Demographics
NPI:1134316201
Name:MEDICAL INFORMATION TECHNOLOGY CONSULTANTS
Entity Type:Organization
Organization Name:MEDICAL INFORMATION TECHNOLOGY CONSULTANTS
Other - Org Name:UROLOGY ASSOCIATES FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDILCIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-756-4999
Mailing Address - Street 1:675 BALLY ROW
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2967
Mailing Address - Country:US
Mailing Address - Phone:419-756-4999
Mailing Address - Fax:419-756-4949
Practice Address - Street 1:675 BALLY ROW
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-2967
Practice Address - Country:US
Practice Address - Phone:419-756-4999
Practice Address - Fax:419-756-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical