Provider Demographics
NPI:1790783991
Name:ADVANCED CARDIOTHORACIC SURGEONS OF NORTHWEST OHIO, INC.
Entity Type:Organization
Organization Name:ADVANCED CARDIOTHORACIC SURGEONS OF NORTHWEST OHIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-251-4364
Mailing Address - Street 1:2213 CHERRY ST
Mailing Address - Street 2:ACC #309
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2603
Mailing Address - Country:US
Mailing Address - Phone:419-251-4364
Mailing Address - Fax:419-251-4922
Practice Address - Street 1:2213 CHERRY ST
Practice Address - Street 2:#309ACC
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2603
Practice Address - Country:US
Practice Address - Phone:419-251-4364
Practice Address - Fax:419-251-4922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0368856Medicaid
OH060027150OtherRR MEDICARE
OH060027150OtherRR MEDICARE