MARYMOUNT PRIMARY CARE SERVICES INC NPI 1639361074

NPI Information

  • NPI: 1639361074
  • Provider Name: MARYMOUNT PRIMARY CARE SERVICES, INC
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • Address: 12000 MCCRACKEN RD
    SUITE 450
    GARFIELD HEIGHTS, OH
    ZIP 44125
  • Phone: (216) 663-7355

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NPI Details

MARYMOUNT PRIMARY CARE SERVICES, INC is an obstetrics gynecology in Garfield Heights, OH. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. MARYMOUNT PRIMARY CARE SERVICES, INC NPI is 1639361074. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12000 MCCRACKEN RD
SUITE 450
GARFIELD HEIGHTS, OH
ZIP 44125-964
Phone: (216) 663-7355
Fax: (216) 663-7193

The provider's authorized official is Peter P Walchanowicz .
The authorized official title is Practice Manager and has the following contact phone number (440) 543-8855.

The enumeration date for this NPI number is 8/9/2007 and was last updated on 5/27/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12087058MEDICAIDOHIO
29265462MEDICARE PINOHIO
3CK0694MEDICARE PINOHIO
4000000564654OTHEROHIOANTHEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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