| Bow Tie Medical Ohio, Llc | |
|
7500 Town Centre Dr Ste 200 Broadview Heights OH 44147-4029 | |
| (877) 283-8863 | |
| (213) 784-5670 |
| Full Name | Bow Tie Medical Ohio, Llc |
|---|---|
| Speciality | General Practice |
| Location | 7500 Town Centre Dr Ste 200, Broadview Heights, Ohio |
| Authorized Official Name and Position | Firouz Daneshgari (CEO/CMO) |
| Authorized Official Contact | 8772838663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bow Tie Medical Ohio, Llc 7750 Town Centre Dr Ste 300 Broadview Heights OH 44147-4040 Ph: (877) 283-8863 | Bow Tie Medical Ohio, Llc 7500 Town Centre Dr Ste 200 Broadview Heights OH 44147-4029 Ph: (877) 283-8863 |
| NPI Number | 1811328065 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 01/20/2022 |
| Medicare PECOS PAC ID | 7315263613 |
|---|---|
| Medicare Enrollment ID | O20150304001189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811328065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Firouz Daneshgari |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1689637597 PECOS PAC ID: 3870550270 Enrollment ID: I20041217000064 |
| Provider Name | Raja Shaheen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275622367 PECOS PAC ID: 5991771750 Enrollment ID: I20121005000632 |
| Provider Name | Kimberly Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578752267 PECOS PAC ID: 7719137298 Enrollment ID: I20130109000235 |
| Provider Name | Kelli Suzanne Buckner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417269622 PECOS PAC ID: 0648413351 Enrollment ID: I20130828000598 |
Marymount Primary Care Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 E Royalton Rd, Broadview Heights, OH 44147 Phone: 440-717-6100 Fax: 440-546-1382 | |
Mark A. Lang, M.d., Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 303 E Royalton Rd, Suite 204, Broadview Heights, OH 44147 Phone: 440-545-2272 Fax: 440-545-5645 | |
Troy W Bishop Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9417 Broadview Rd, Broadview Heights, OH 44147 Phone: 440-545-2272 Fax: 440-545-5645 | |
Paul Bures D.o. Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9417 Broadview Rd, Broadview Heights, OH 44147 Phone: 440-545-2272 | |
University Hospitals Case Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5901 E Royalton Rd, Broadview Heights, OH 44147 Phone: 216-844-8447 |