MEDICARE: INMAN FAMILY HEALTH & WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34007915	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760671499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INMAN FAMILY HEALTH & WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	125 CANTON RD NW
Second Line	:	SUITE A
City	:	CARROLLTON
State	:	OH
Zip	:	44615-1009
Country	:	US
Telephone Number	:	330-627-8163
Fax Number	:	330-627-0197

Provider Business Practice Location Address
First Line	:	125 CANTON RD NW
Second Line	:	SUITE A
City	:	CARROLLTON
State	:	OH
Zip	:	44615-1009
Country	:	US
Telephone Number	:	330-627-8163
Fax Number	:	330-627-0197

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MATTHEW D INMAN
Credential	:	D.O.
Telephone Number	:	330-627-8163

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	12/10/2008

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