Provider Demographics
NPI:1881991230
Name:SINUS CENTER OF AMERICA LLC
Entity type:Organization
Organization Name:SINUS CENTER OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:KWYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:567-455-0300
Mailing Address - Street 1:1000 REGENCY CT
Mailing Address - Street 2:210
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3091
Mailing Address - Country:US
Mailing Address - Phone:567-455-0300
Mailing Address - Fax:
Practice Address - Street 1:1000 REGENCY CT
Practice Address - Street 2:210
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3091
Practice Address - Country:US
Practice Address - Phone:567-455-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.057206207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA83083Medicare UPIN