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General NPI Number Information
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NPI Number | 1437284015
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Entity Type | Organization
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Legal Business Name | NORTH COAST ORTHOPEDIC SURGERY INC.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 629 BARTSON RD
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City | FREMONT
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State | OH
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Zip | 43420-9672
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Country | US
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Telephone | 419-355-9800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 546
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City | FREMONT
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State | OH
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Zip | 43420-0546
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Country | US
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Telephone | 419-355-9800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN M BONDRA
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Credential | D.O.
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Telephone | 419-355-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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