| Millersburg Clinic, Inc. | |
|
5354 Township Road 336 Ste B Millersburg OH 44654 | |
| (330) 674-3434 | |
| (330) 674-3731 |
| Full Name | Millersburg Clinic, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5354 Township Road 336, Millersburg, Ohio |
| Authorized Official Name and Position | Butros Latouf (MD) |
| Authorized Official Contact | 3306743434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millersburg Clinic, Inc. 5354 Township Road 336 Ste B Millersburg OH 44654 Ph: (330) 674-3434 | Millersburg Clinic, Inc. 5354 Township Road 336 Ste B Millersburg OH 44654 Ph: (330) 674-3434 |
| NPI Number | 1215971643 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 01/24/2019 |
| Medicare PECOS PAC ID | 1557266210 |
|---|---|
| Medicare Enrollment ID | O20031204001125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215971643 | NPI | - | NPPES |
| 2091678 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 350631710 (Ohio) | Primary |
| Provider Name | Butros Latouf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851396840 PECOS PAC ID: 0042115701 Enrollment ID: I20031204001180 |
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