| West Market Street Family Phys | |
|
915 W Market St Suite E Lima OH 45805-2768 | |
| (419) 229-4747 | |
| (419) 224-3348 |
| Full Name | West Market Street Family Phys |
|---|---|
| Speciality | Family Medicine |
| Location | 915 W Market St, Lima, Ohio |
| Authorized Official Name and Position | David J Neidhardt (PRESIDENT) |
| Authorized Official Contact | 4192294747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Market Street Family Phys 915 W Market St Suite E Lima OH 45805-2768 Ph: (419) 229-4747 | West Market Street Family Phys 915 W Market St Suite E Lima OH 45805-2768 Ph: (419) 229-4747 |
| NPI Number | 1225159791 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 04/25/2012 |
| Medicare PECOS PAC ID | 7517943269 |
|---|---|
| Medicare Enrollment ID | O20040624001692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225159791 | NPI | - | NPPES |
| C14881 | Other | OH | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Manuel Florent Julian Patricio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992761159 PECOS PAC ID: 3375445612 Enrollment ID: I20040126000624 |
| Provider Name | Edward Lewis Tremoulis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376595728 PECOS PAC ID: 0143123307 Enrollment ID: I20040127001023 |
| Provider Name | David J Neidhardt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396797510 PECOS PAC ID: 2365345527 Enrollment ID: I20040127001067 |
| Provider Name | Madeline Agosto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053363580 PECOS PAC ID: 8921085705 Enrollment ID: I20120220000410 |
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