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General NPI Number Information
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NPI Number | 1487922548
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Entity Type | Organization
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Legal Business Name | NORTHERN OHIO MEDICAL SPECIALISTS, LLC
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 2800 HAYES AVE # BDLGC130
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City | SANDUSKY
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State | OH
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Zip | 44870
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Country | US
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Telephone | 419-502-5941
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Fax | 419-502-5942
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Provider Business Mailing Address
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Address Line | PO BOX 8372
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City | CAROL STREAM
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State | IL
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Zip | 60197-8372
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Country | US
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Telephone | 419-609-1112
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Fax | 419-609-1123
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Authorized Official
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Title or Position | CREDNTIALING DIRECTOR
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Name | DAWN WITTER
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Credential |
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Telephone | 216-298-1213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 10G07212003
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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