| Mr Todd S Bolotin, MD | |
|
6252 Mahoning Ave, Austintown, OH 44515-2003 | |
| (330) 792-7418 | |
| (330) 792-9092 |
| Full Name | Mr Todd S Bolotin |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 6252 Mahoning Ave, Austintown, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457336497 | NPI | - | NPPES |
| 000000349348 | Other | OH | ANTHEM |
| 0858433 | Medicaid | OH | |
| 000000028430 | Other | OH | ANTHEM |
| 001522135-0005 | Other | OH | PENNSYLVANIA MEDICAID |
| 000000381140 | Other | OH | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 35060979B (Ohio) | Primary |
| Entity Name | Mahoning Valley Emergency Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003869652 PECOS PAC ID: 5698758993 Enrollment ID: O20040609000114 |
| Entity Name | Mves Boardman Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205888237 PECOS PAC ID: 4688694722 Enrollment ID: O20051202000794 |
| Entity Name | Ues Ahuja Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467883934 PECOS PAC ID: 5496985467 Enrollment ID: O20140313001425 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Todd S Bolotin, MD 5700 Darrow Rd, Suite 106, Hudson, OH 44236-5021 Ph: (330) 656-5911 | Mr Todd S Bolotin, MD 6252 Mahoning Ave, Austintown, OH 44515-2003 Ph: (330) 792-7418 |
Mr. Glenn W Ray, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6252 Mahoning Avenue, Austintown, OH 44515 Phone: 330-792-7418 Fax: 330-792-9092 | |
John Manenti, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 5533 Mahoning Ave Fl 2, Austintown, OH 44515 Phone: 330-793-2707 | |
Waleed Mansour, M.DL Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1397 S Canfield Niles Rd, Unit 1, Austintown, OH 44515 Phone: 330-953-0129 Fax: 330-953-0650 | |
Matthew Carl Mueller, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 102 Westchester Dr, Austintown, OH 44515 Phone: 330-270-3660 | |
Gilbert Palmer, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6252 Mahoning Ave, Austintown, OH 44515 Phone: 330-792-7418 Fax: 330-656-5901 |