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NPI Code Detail

MEDICARE: UNIVERSITY PRIMARY CARE PRACTICES INC

MEDICARE: UNIVERSITY PRIMARY CARE PRACTICES 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
1207V00000XObstetrics & Gynecology PhysicianOH

Other Identifiers

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

General Provider Information

NPI Number : 1942402565
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY PRIMARY CARE PRACTICES INC
Provider Business Mailing Address
First Line : PO BOX 8792
Second Line :
City : BELFAST
State : ME
Zip : 04915-8792
Country : US
Telephone Number : 440-998-1329
Fax Number : 440-998-2623
Provider Business Practice Location Address
First Line : 2210 S RIDGE RD E
Second Line :
City : ASHTABULA
State : OH
Zip : 44004-4459
Country : US
Telephone Number : 440-998-1329
Fax Number : 440-992-2623
Authorized Official
Title or Position : DIRECTOR OF BILLING SERVICES
Name : MR. STEVE LADER
Credential :
Telephone Number : 216-383-6480
Provider Enumeration Date : 06/05/2007
Last Update Date : 04/09/2010

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Directions to “UNIVERSITY PRIMARY CARE PRACTICES INC ” Practice Location

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