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General NPI Number Information
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NPI Number | 1952724940
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Entity Type | Organization
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Legal Business Name | NORTHWEST OHIO SURGICAL CENTERS, INC
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 5688 MONROE ST
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City | SYLVANIA
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State | OH
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Zip | 43560-2736
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Country | US
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Telephone | 419-517-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 5688 MONROE ST
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City | SYLVANIA
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State | OH
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Zip | 43560-2736
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Country | US
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Telephone | 419-517-4404
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ORAL SURGEON
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Name | DR. STEPHEN SHALL
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Credential |
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Telephone | 419-517-4404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 16634
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License Number State | OH
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