Provider Demographics
NPI:1457422909
Name:BELLINI INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:BELLINI INTERNAL MEDICINE, LLC
Other - Org Name:DBA: MIDDLEFIELD PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZMJOUEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-479-6371
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-1027
Mailing Address - Country:US
Mailing Address - Phone:440-632-0770
Mailing Address - Fax:440-632-0321
Practice Address - Street 1:16030 E HIGH ST
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9474
Practice Address - Country:US
Practice Address - Phone:440-632-0770
Practice Address - Fax:440-632-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082760207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3136136Medicaid
9364962Medicare PIN