Healthcare Provider Details

I. General information

NPI: 1811269681
Provider Name (Legal Business Name): OHIO NORTH EAST HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 E MARKET ST
WARREN OH
44483-6602
US

IV. Provider business mailing address

726 WICK AVENUE
YOUNGSTOWN OH
44505-2827
US

V. Phone/Fax

Practice location:
  • Phone: 330-393-2585
  • Fax: 330-884-6120
Mailing address:
  • Phone: 330-747-9551
  • Fax: 330-884-6120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD DWINNELLS
Title or Position: CEO
Credential: MD
Phone: 330-747-9551