MAIN STREET MEDICAL GROUP, LLC


Address: 36001 Euclid Ave, C-17, Willoughby, OH 44094-4643
Phone: 4409464662

MAIN STREET MEDICAL GROUP, LLC (NPI# 1063683662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063683662
Entity Type Organization
Organization Name MAIN STREET MEDICAL GROUP, LLC
Practice Address 36001 Euclid Ave
C-17
Willoughby
OH 44094-4643
Practice Telephone 4409464662
Practice Fax Number 4409464084
Mailing Telephone 4409464662
Mailing Fax Number 4409464084
Enumeration Date 2008-03-21
Last Update Date 2008-09-20
Authorized Official Name DR. RANDALL SCOTT SCHWARTZ (PROPRIETOR)
Authorized Official Telephone 4409464662
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine 35-06-0015 OH Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OH 2817321 05
OH ANTHEM BLUE SHIELD 000000562822 01

Office Location

Street Address 36001 EUCLID AVE
C-17
City WILLOUGHBY
State OH
Zip Code 44094-4643

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013907989 Ming Huei Phillip Chiang Family Medicine 36001 Euclid Ave, B4, Willoughby, OH 44094-4643 2005-10-24
1992306633 Alisha Howland Nurse Practitioner 36001 Euclid Ave, Willoughby, OH 44094-4643 2020-11-07
1699140202 Phillip W Wallace Dds Inc Dentist 36001 Euclid Ave, Suite A-15, Willoughby, OH 44094-4643 2015-12-08
1366787624 Anthony James Lorenzo Acupuncturist 36001 Euclid Ave, Suite A-6, Willoughby, OH 44094-4643 2012-11-27
1447542790 Austin Charles Homrighaus Acupuncturist 36001 Euclid Ave, Suite B-7, Willoughby, OH 44094-4643 2011-05-04
1336464528 Enlightened Health Management LLC Pain Medicine 36001 Euclid Ave, Willoughby, OH 44094-4643 2010-03-31
1124255278 Lake Hospital System, Inc. Surgery 36001 Euclid Ave, B-3, Willoughby, OH 44094-4643 2009-06-16
1134314644 Russell Allen Blair Internal Medicine 36001 Euclid Ave, C19, Willoughby, OH 44094-4643 2007-09-07
1295929792 Jennifer L Kriessler Nurse Practitioner 36001 Euclid Ave, C6, Willoughby, OH 44094-4643 2007-08-29
1871798801 M H Phillip Chiang Md Inc Family Medicine 36001 Euclid Ave, B 4, Willoughby, OH 44094-4643 2007-06-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518574367 Bj's Wholesale Club Inc. Eyewear Supplier (Equipment, not the service) 36596 Euclid Ave, Willoughby, OH 44094 2020-09-25
1679111322 Megan King Nurse Practitioner 4078 Erie Street, Unit B, Willoughby, OH 44094 2019-12-12
1124661525 Mind and Body Infusion Therapies, LLC Clinic/Center 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 2019-10-18
1679125637 Christina Maria Chandler Family Medicine 39021 Signature Circle, Willoughby, OH 44094 2019-07-10
1467920595 Rachel Curry Specialist/Technologist 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 2018-11-07
1437649753 Katie Lauren Greenaway Registered Nurse 5103 Robinhood Dr, Willoughby, OH 44094 2018-05-11
1003346131 Heather Marie Hayes Licensed Practical Nurse 38882 Mentor Ave., Willoughby, OH 44094 2017-06-12
1609305028 Ann Marie Mason Counselor 38882 Mentor Avenue, Willoughby, OH 44094 2017-06-08
1285173005 Mattie Diann Towns-scott Social Worker 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 2017-02-13
1447797329 Therese Benz General Acute Care Hospital 96000 Euclid Ave., Willoughby, OH 44094 2017-01-30
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619234689 John William Horinger Jr. Internal Medicine 36100 Euclid Ave Ste 240, Willoughby, OH 44094-4427 2012-04-16
1427291061 Adriatik Kellici Internal Medicine 38582 Heritage Ct, Willoughby, OH 44094-8839 2009-04-13
1164697629 Lake Hospital System Inc Internal Medicine 2747 Som Center Rd, Willoughby, OH 44094-9164 2008-04-25
1356566848 Joel Stuart Steinberg Internal Medicine 5370 Som Center Rd, Willoughby, OH 44094-4208 2007-04-17
1306967807 Drs Byers & Birnbaum Inc Internal Medicine 35040 Chardon Rd Ste G200, Willoughby, OH 44094-9055 2007-04-02
1982782363 Dawn Renee Joseph Internal Medicine 5105 Som Center Rd., Kaiser Permanente, Willoughby, OH 44094 2006-11-01
1487750477 Marinela L Turc Internal Medicine 36001 Euclid Ave Ste B11, Willoughby, OH 44094-4651 2006-09-16
1861508103 Robert T. Mulcahy Internal Medicine 36100 Euclid Avenue #240, Willoughby, OH 44094 2006-08-21
1144756248 Jennifer Ashley Bostick Internal Medicine 36000 Euclid Ave, Willoughby, OH 44094-4625 2017-05-10
1861928962 Andrew Bostick Internal Medicine 36000 Euclid Ave, Willoughby, OH 44094-4625 2017-05-10
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Competitor

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City WILLOUGHBY
Zip Code 44094

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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