Provider Demographics
NPI:1902856487
Name:UNION INTERNAL MEDICINE SPECIALTIES LTD.
Entity Type:Organization
Organization Name:UNION INTERNAL MEDICINE SPECIALTIES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PADRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-364-5559
Mailing Address - Street 1:515 UNION AVE
Mailing Address - Street 2:SUITE 187
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-3004
Mailing Address - Country:US
Mailing Address - Phone:330-343-4411
Mailing Address - Fax:330-336-4111
Practice Address - Street 1:515 UNION AVE
Practice Address - Street 2:SUITE 187
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-3004
Practice Address - Country:US
Practice Address - Phone:330-343-4411
Practice Address - Fax:330-336-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2193595Medicaid
OH2193595Medicaid