Provider Demographics
NPI:1912198391
Name:MID WEST SLEEP CONSULTANTS, LLC
Entity Type:Organization
Organization Name:MID WEST SLEEP CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:JAYANTILAL
Authorized Official - Last Name:VAIDYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-520-2813
Mailing Address - Street 1:427 GLESSNER AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2141
Mailing Address - Country:US
Mailing Address - Phone:419-520-2813
Mailing Address - Fax:419-520-2856
Practice Address - Street 1:427 GLESSNER AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2141
Practice Address - Country:US
Practice Address - Phone:419-520-2813
Practice Address - Fax:419-520-2856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-059862207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty