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1300 Greenville Rd. St. Marys OH 45885 | |
(419) 394-4813 | |
(419) 394-1546 |
Full Name | |
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Speciality | Family Medicine |
Location | 1300 Greenville Rd., St. Marys, Ohio |
Authorized Official Name and Position | Padmaja Chalasani (MD/OWNER) |
Authorized Official Contact | 4193944813 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 719 1300 Greenville Rd. St. Marys OH 45885 Ph: (419) 394-4813 | 1300 Greenville Rd. St. Marys OH 45885 Ph: (419) 394-4813 |
NPI Number | 1487664306 |
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Provider Enumeration Date | 08/09/2006 |
Last Update Date | 01/06/2017 |
Identifier | Type | State | Issuer |
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1487664306 | NPI | - | NPPES |
20049876 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |