Provider Demographics
NPI:1407886674
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:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDLMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-931-3030
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:43551-5662
Mailing Address - Country:US
Mailing Address - Phone:419-931-3030
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:43551-5662
Practice Address - Country:US
Practice Address - Phone:419-931-3030
Practice Address - Fax:419-931-3048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0529075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0529075Medicaid
OH2131222Medicaid
OHH06854Medicare UPIN
OH0529075Medicaid