Provider Demographics
NPI:1659369452
Name:PHYSICIANS FOR PULMONARY & CRITICAL CARE CORP
Entity Type:Organization
Organization Name:PHYSICIANS FOR PULMONARY & CRITICAL CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DINGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-446-1423
Mailing Address - Street 1:1450 SOM CENTER RD
Mailing Address - Street 2:#25
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2118
Mailing Address - Country:US
Mailing Address - Phone:440-446-1423
Mailing Address - Fax:440-446-1498
Practice Address - Street 1:1450 SOM CENTER RD
Practice Address - Street 2:#25
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2118
Practice Address - Country:US
Practice Address - Phone:440-446-1423
Practice Address - Fax:440-446-1498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH049397Medicaid
OH9307336Medicare PIN
OH049397Medicaid
OH9307332Medicare PIN
OH9307338Medicare PIN
OH9307341Medicare PIN
OH9307345Medicare PIN
OH9307331Medicare PIN
OH9307334Medicare PIN
OH9307337Medicare PIN