| Bloomington Medical Services Llc | |
|
1761 Beall Ave Wooster OH 44691-2342 | |
| (330) 263-8428 | |
| (330) 263-8190 |
| Full Name | Bloomington Medical Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1761 Beall Ave, Wooster, Ohio |
| Authorized Official Name and Position | Laurie M Tate (CREDENTIALING) |
| Authorized Official Contact | 3302638763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomington Medical Services Llc 1761 Beall Ave Wooster OH 44691-2342 Ph: (330) 263-8428 | Bloomington Medical Services Llc 1761 Beall Ave Wooster OH 44691-2342 Ph: (330) 263-8428 |
| NPI Number | 1528246683 |
|---|---|
| Provider Enumeration Date | 01/31/2008 |
| Last Update Date | 02/05/2015 |
| Medicare PECOS PAC ID | 9032297627 |
|---|---|
| Medicare Enrollment ID | O20080422000953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528246683 | NPI | - | NPPES |
| 2836560 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35077131 (Ohio) | Primary |
| Provider Name | Michael M Hughes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043312978 PECOS PAC ID: 7719890581 Enrollment ID: I20031209000810 |
| Provider Name | Cyril S Ofori |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427168848 PECOS PAC ID: 0840103735 Enrollment ID: I20031210000101 |
| Provider Name | Srinivasa Dinakar Satti |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1265411243 PECOS PAC ID: 6305734898 Enrollment ID: I20040308000046 |
| Provider Name | Loren M Kirchner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952382285 PECOS PAC ID: 2163419011 Enrollment ID: I20040430000638 |
| Provider Name | Barbara J Tickton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588711246 PECOS PAC ID: 3971562034 Enrollment ID: I20041005001157 |
| Provider Name | David Akwainja Kittoe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730149154 PECOS PAC ID: 9931164555 Enrollment ID: I20041123000606 |
| Provider Name | Stacy L Hollister |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134159577 PECOS PAC ID: 3577505932 Enrollment ID: I20050525000880 |
| Provider Name | Mary C Sementi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770653966 PECOS PAC ID: 7618946609 Enrollment ID: I20051104000377 |
| Provider Name | Katie B Dossi |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144274192 PECOS PAC ID: 3779502992 Enrollment ID: I20051202000647 |
| Provider Name | Mark J Tereletsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881673614 PECOS PAC ID: 8426079849 Enrollment ID: I20051213000847 |
| Provider Name | Teresa H Ghazoul |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1265475370 PECOS PAC ID: 8628080876 Enrollment ID: I20060707000128 |
| Provider Name | Christopher Behr Ranney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265402499 PECOS PAC ID: 5496758146 Enrollment ID: I20060817000623 |
| Provider Name | Arsal Ahmad |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1700893104 PECOS PAC ID: 7012913015 Enrollment ID: I20061016000167 |
| Provider Name | Arshad Rehan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1922171412 PECOS PAC ID: 1153338215 Enrollment ID: I20070126000127 |
| Provider Name | Joel R Simmons |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1487861688 PECOS PAC ID: 6406955236 Enrollment ID: I20070620000196 |
| Provider Name | Eric R.a. Jopperi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952421638 PECOS PAC ID: 4284733635 Enrollment ID: I20070626000127 |
| Provider Name | James Mooney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740292853 PECOS PAC ID: 8325148885 Enrollment ID: I20070712000522 |
| Provider Name | Anand Kancherla |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538195201 PECOS PAC ID: 4486728219 Enrollment ID: I20080728000715 |
| Provider Name | Steven Allen Wanek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194995480 PECOS PAC ID: 0547324394 Enrollment ID: I20090123000137 |
| Provider Name | John M Weeman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134100308 PECOS PAC ID: 0547287419 Enrollment ID: I20090923000065 |
| Provider Name | Douglas R Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902883507 PECOS PAC ID: 8628119724 Enrollment ID: I20100112000440 |
| Provider Name | Mansour Isckarus |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1770581787 PECOS PAC ID: 4183711229 Enrollment ID: I20100125000016 |
| Provider Name | Toni Michelle King |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1275504672 PECOS PAC ID: 9638208390 Enrollment ID: I20100519000276 |
| Provider Name | Raymond J Baddour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508875634 PECOS PAC ID: 3971634304 Enrollment ID: I20100629000840 |
| Provider Name | Nagapradeep Nagajothi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1144218074 PECOS PAC ID: 7719910918 Enrollment ID: I20100803000215 |
| Provider Name | Paul R Nielsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912187071 PECOS PAC ID: 0941334510 Enrollment ID: I20100818000403 |
| Provider Name | Sharon E Marcanthony |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508046012 PECOS PAC ID: 8921284894 Enrollment ID: I20110511000396 |
| Provider Name | Jennifer R Vandevelde |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801036124 PECOS PAC ID: 4688851751 Enrollment ID: I20110527000354 |
| Provider Name | Bruce W Arthur |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205956018 PECOS PAC ID: 4082882873 Enrollment ID: I20110721000704 |
| Provider Name | Prakash Chand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275812497 PECOS PAC ID: 8527232891 Enrollment ID: I20111122000930 |
| Provider Name | Anne M Chicorelli |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922339308 PECOS PAC ID: 5092980060 Enrollment ID: I20111203000049 |
| Provider Name | Molly S Hastings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518014562 PECOS PAC ID: 3072772284 Enrollment ID: I20120307000779 |
| Provider Name | Elizabeth M Yu |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699896688 PECOS PAC ID: 7214028620 Enrollment ID: I20120907000224 |
| Provider Name | Autumn Lee White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992967467 PECOS PAC ID: 4486807716 Enrollment ID: I20130116000428 |
| Provider Name | David A Delorenzo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942285051 PECOS PAC ID: 9830169184 Enrollment ID: I20130311000059 |
| Provider Name | Derek Brown |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124348842 PECOS PAC ID: 7911911342 Enrollment ID: I20130328000268 |
| Provider Name | Kathryn C Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871804575 PECOS PAC ID: 0446492706 Enrollment ID: I20130815000655 |
| Provider Name | Christina S Muller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154762235 PECOS PAC ID: 6901049873 Enrollment ID: I20130823001207 |
| Provider Name | Ama Nkyima Nuamah |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1225316276 PECOS PAC ID: 2668696493 Enrollment ID: I20140617000931 |
| Provider Name | Joseph S Borruso |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689804270 PECOS PAC ID: 9931324167 Enrollment ID: I20140702001088 |
| Provider Name | Ifijen M Oleghe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851661995 PECOS PAC ID: 9335364090 Enrollment ID: I20140714001188 |
| Provider Name | Tyra R Schlabach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710395975 PECOS PAC ID: 4082832977 Enrollment ID: I20140908001048 |
| Provider Name | Tamera L Robotham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164656971 PECOS PAC ID: 1557504941 Enrollment ID: I20140916002064 |
| Provider Name | Tim Ivan Moomaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386035954 PECOS PAC ID: 6103144597 Enrollment ID: I20150415000918 |
| Provider Name | Stacey E Swindell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588052757 PECOS PAC ID: 1153640933 Enrollment ID: I20150428002272 |
| Provider Name | Mark A Yoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235597048 PECOS PAC ID: 3173828308 Enrollment ID: I20160225000435 |
| Provider Name | Anthony M Calabretta |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003106089 PECOS PAC ID: 7618110271 Enrollment ID: I20160721001178 |
| Provider Name | Alycia Gail Findlay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720420052 PECOS PAC ID: 4486963493 Enrollment ID: I20160727001810 |
| Provider Name | Salvatore J Savona |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1841533312 PECOS PAC ID: 1456580182 Enrollment ID: I20160809001052 |
| Provider Name | Steven A Walston |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1053623397 PECOS PAC ID: 0648411272 Enrollment ID: I20160829002050 |
| Provider Name | Eric J Turney |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1649478041 PECOS PAC ID: 9638300437 Enrollment ID: I20161118001672 |
| Provider Name | Kelly Renee Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538611934 PECOS PAC ID: 7416237557 Enrollment ID: I20161207002530 |
| Provider Name | Joseph Prah |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1689787731 PECOS PAC ID: 7911071956 Enrollment ID: I20170202002452 |
| Provider Name | Carmen Barkman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720526056 PECOS PAC ID: 0941585558 Enrollment ID: I20170322001827 |
| Provider Name | Efewongbe B Oleghe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003224577 PECOS PAC ID: 8224305214 Enrollment ID: I20170523000787 |
| Provider Name | John H Roof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275067670 PECOS PAC ID: 6204104094 Enrollment ID: I20170620001976 |
| Provider Name | Chinedu Angela Igwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710207519 PECOS PAC ID: 1951545839 Enrollment ID: I20180108002964 |
| Provider Name | Nana Yaa A Koram |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518349885 PECOS PAC ID: 7214291756 Enrollment ID: I20180508002673 |
| Provider Name | Joseph Baah Agyepong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164817003 PECOS PAC ID: 7315247681 Enrollment ID: I20180515002057 |
| Provider Name | Nicholas F Kotsonis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487922241 PECOS PAC ID: 0749587178 Enrollment ID: I20180703003207 |
| Provider Name | Ahmad S Siddiqi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841532264 PECOS PAC ID: 5092065854 Enrollment ID: I20180829002236 |
| Provider Name | Joseph A Wapenski |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1487654281 PECOS PAC ID: 1153229463 Enrollment ID: I20190214001619 |
| Provider Name | Charles Jason Novince |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518500990 PECOS PAC ID: 0941634018 Enrollment ID: I20191223002386 |
| Provider Name | Stacie R Kobylanski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841830916 PECOS PAC ID: 9537597992 Enrollment ID: I20200317002642 |
| Provider Name | Kimberly Miller |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1730712530 PECOS PAC ID: 5193155778 Enrollment ID: I20200422001878 |
| Provider Name | Dannielle L Mellen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083846521 PECOS PAC ID: 3870923287 Enrollment ID: I20200427002681 |
| Provider Name | Lauren M Rufener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811458300 PECOS PAC ID: 9638509938 Enrollment ID: I20200429002525 |
| Provider Name | Sara K Keller |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487046348 PECOS PAC ID: 9537435979 Enrollment ID: I20200827003578 |
| Provider Name | Farouk M Belal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1629053996 PECOS PAC ID: 6507847241 Enrollment ID: I20201005001104 |
| Provider Name | Erin Barner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467003673 PECOS PAC ID: 8123430014 Enrollment ID: I20201217001961 |
| Provider Name | Steven L Seese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053846725 PECOS PAC ID: 4082984802 Enrollment ID: I20210302001379 |
| Provider Name | Jessica Dawn Ungerer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295352565 PECOS PAC ID: 1456769926 Enrollment ID: I20210422003072 |
| Provider Name | Megan M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508450586 PECOS PAC ID: 0547679151 Enrollment ID: I20210512001324 |
| Provider Name | Rahsaan Friend |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275730657 PECOS PAC ID: 2769623701 Enrollment ID: I20210601002107 |
| Provider Name | Michael Bortz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497166243 PECOS PAC ID: 2769763895 Enrollment ID: I20210623003435 |
| Provider Name | Ryan M Burkholder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073045597 PECOS PAC ID: 8325475387 Enrollment ID: I20210709001894 |
| Provider Name | Ahmed Amro |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952716789 PECOS PAC ID: 2062631138 Enrollment ID: I20210715002411 |
| Provider Name | Suzanne M Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083138051 PECOS PAC ID: 4789089137 Enrollment ID: I20210823002163 |
| Provider Name | Jennifer E Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811565286 PECOS PAC ID: 1759786122 Enrollment ID: I20210823003088 |
| Provider Name | Jenny R Deforeest |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245369784 PECOS PAC ID: 1951464163 Enrollment ID: I20211018001005 |
| Provider Name | Kirstin R Fortune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265099121 PECOS PAC ID: 1850784414 Enrollment ID: I20220203002288 |
| Provider Name | Scott W.n. Mollison |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346725157 PECOS PAC ID: 6103179312 Enrollment ID: I20220718003788 |
| Provider Name | Paige Pierce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003348996 PECOS PAC ID: 0749531945 Enrollment ID: I20220819002343 |
| Provider Name | Joseph Sailors |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1861461311 PECOS PAC ID: 5597828848 Enrollment ID: I20220830000517 |
| Provider Name | Lindsay Collins |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407465453 PECOS PAC ID: 9931504644 Enrollment ID: I20220913002140 |
| Provider Name | Candis B Nolletti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962166983 PECOS PAC ID: 7214303023 Enrollment ID: I20221019002498 |
| Provider Name | Kelly Williams |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518672955 PECOS PAC ID: 3577935709 Enrollment ID: I20230215002744 |
| Provider Name | Emily Ferullo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144945429 PECOS PAC ID: 1658745013 Enrollment ID: I20230327000238 |
| Provider Name | Alexander Mosteller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215564406 PECOS PAC ID: 1355772880 Enrollment ID: I20230620000819 |
| Provider Name | Achintya Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619539004 PECOS PAC ID: 6507194453 Enrollment ID: I20230911002501 |
| Provider Name | Julia Hanshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215613641 PECOS PAC ID: 5890159594 Enrollment ID: I20230914000180 |
| Provider Name | Chirag Berry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164778361 PECOS PAC ID: 5193953214 Enrollment ID: I20230921000983 |
| Provider Name | Maddison Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952009466 PECOS PAC ID: 6002261401 Enrollment ID: I20231004002521 |
| Provider Name | Robert Siska |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1396278552 PECOS PAC ID: 1850662024 Enrollment ID: I20231019001452 |
| Provider Name | Lamia Aljundi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1780030619 PECOS PAC ID: 6002101755 Enrollment ID: I20231204001699 |
| Provider Name | Jennifer A Skruck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205024957 PECOS PAC ID: 6800230020 Enrollment ID: I20240215002965 |
| Provider Name | Heather Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558106492 PECOS PAC ID: 0749729044 Enrollment ID: I20240910001837 |
| Provider Name | Holly M Bordner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720824741 PECOS PAC ID: 3173056124 Enrollment ID: I20241029002220 |
| Provider Name | Ashraf Mostafa |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1396976080 PECOS PAC ID: 4486952348 Enrollment ID: I20250604002181 |
Tina Nelson Md & Associates Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3477 Commerce Pkwy, Suite A, Wooster, OH 44691 Phone: 330-345-8410 Fax: 330-345-8458 | |
Paul Nielsen Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 E Milltown Rd, Suite 105, Wooster, OH 44691 Phone: 330-345-8060 Fax: 330-345-5983 | |
Wooster Family Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3477 Commerce Pkwy, Suite A, Wooster, OH 44691 Phone: 330-601-0999 | |
Wooster Clinic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1740 Cleveland Rd, Wooster, OH 44691 Phone: 330-287-4500 | |
My Urban Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 Beall Ave, Wooster, OH 44691 Phone: 330-264-0247 Fax: 330-264-0463 | |
Great Health Medical Oh Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1552 N Honeytown Rd, Wooster, OH 44691 Phone: 718-470-0288 | |
Scott A Hannan Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3477 Commerce Parkway, Suite A, Wooster, OH 44691 Phone: 330-601-0999 Fax: 330-601-0935 |