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General NPI Number Information
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NPI Number | 1477548790
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Entity Type | Organization
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Legal Business Name | CARDIOVASULAR PHYSICIANS/MERCY HEALTH PARTNERS,LLC
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 2409 CHERRY ST
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City | TOLEDO
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State | OH
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Zip | 43608-2625
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Country | US
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Telephone | 419-251-4169
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Fax | 419-251-3776
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Provider Business Mailing Address
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Address Line | 2409 CHERRY ST
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City | TOLEDO
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State | OH
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Zip | 43608-2625
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Country | US
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Telephone | 419-251-4169
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Fax | 419-251-3776
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MARILYN MARIE GAGNE
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Credential | RCIS
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Telephone | 419-251-4169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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