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General NPI Number Information
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NPI Number | 1396603148
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Entity Type | Organization
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Legal Business Name | PROMEDICA CENTRAL PHYSICIANS
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1 OWENS CORNING PKWY # B-2
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City | TOLEDO
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State | OH
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Zip | 43659-1000
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Country | US
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Telephone | 567-585-0060
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Fax | 567-455-5902
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Provider Business Mailing Address
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Address Line | 100 MADISON AVE FL 3
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City | TOLEDO
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State | OH
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Zip | 43604-1516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, SYSTEM CREDENTIALING
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Name | TANYA WINES
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Credential |
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Telephone | 567-585-0422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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