MEDICARE: NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0529075	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407886674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.

Provider Business Mailing Address
First Line	:	28555 STARBRIGHT BLVD
Second Line	:	SUITE B
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-5662
Country	:	US
Telephone Number	:	419-931-3030
Fax Number	:	419-931-3048

Provider Business Practice Location Address
First Line	:	28555 STARBRIGHT BLVD
Second Line	:	SUITE B
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-5662
Country	:	US
Telephone Number	:	419-931-3030
Fax Number	:	419-931-3048

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ADRIENNE SEDLMEIER
Credential	:	M.D.
Telephone Number	:	419-931-3030

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	08/01/2011

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