| Lawrence John Fanelly Jr, DO | |
|
2600 Navarre Ave, Oregon, OH 43616-3207 | |
| (419) 696-7216 | |
| (419) 696-2123 |
| Full Name | Lawrence John Fanelly Jr |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 48 Years |
| Location | 2600 Navarre Ave, Oregon, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285614503 | NPI | - | NPPES |
| 3402510110 | Medicaid | MI | |
| 0494924 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 34003344F (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy St Vincent Medical Center | Toledo, OH | Hospital |
| Mercy Health - Tiffin Hospital | Tiffin, OH | Hospital |
| Mercy Health - Defiance Hospital | Defiance, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Consulting Pathologists Corp | 3577597277 | 7 |
| Entity Name | Consulting Pathologists Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740288471 PECOS PAC ID: 3577597277 Enrollment ID: O20050922000183 |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence John Fanelly Jr, DO P.o. Box 1188, Bowling Green, OH 43402-1188 Ph: (419) 698-9711 | Lawrence John Fanelly Jr, DO 2600 Navarre Ave, Oregon, OH 43616-3207 Ph: (419) 696-7216 |
Alec Nooree Mian, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 2600 Navarre Ave, St Charles Mercy Hospital, Oregon, OH 43616 Phone: 419-696-7216 Fax: 419-696-2123 | |
Dr. Stacie Lynn Roshong-denk, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 2600 Navarre Ave, Oregon, OH 43616 Phone: 419-696-7200 |