MARY WONDERLY MD LLC (NPI# 1912167750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912167750 |
| Entity Type | Organization |
| Organization Name | MARY WONDERLY MD LLC |
| Practice Address |
2575 Hayes Ave Ste 5 Fremont OH 43420-5201 |
| Practice Telephone | 4193323560 |
| Practice Fax Number | 4193323565 |
| Mailing Telephone | 4193323560 |
| Mailing Fax Number | 4193323565 |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-11-26 |
| Authorized Official Name | DENISE KERLIN (OFFICE MANAGER) |
| Authorized Official Telephone | 4193323560 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35-082561 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2825045 | 05 |
| Street Address |
2575 HAYES AVE STE 5 |
| City | FREMONT |
| State | OH |
| Zip Code | 43420-5201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596570 | Trisha D Hamm | Nurse Practitioner | Walk In Urgent Care, 2180 Sean Dr., #6b, Fremont, OH 43420 | 2019-03-06 |
| 1558886051 | Kortney Blair Potridge | Homemaker | 1718 Buckland Avenue, Fremont, OH 43420 | 2017-08-07 |
| 1699134015 | Gentle Caring Dentistry of Fremont Ohio | Dentist | 2430 Enterprise St, Fremont, OH 43420 | 2016-02-12 |
| 1033574587 | Alyssa Dickman | Physical Therapy Assistant | 1310 Chestnut St, Fremont, OH 43420 | 2015-12-29 |
| 1437566734 | Michael Allen Koebel | Registered Nurse | 1728 Oak Harbor Rd, Fremont, OH 43420 | 2014-07-18 |
| 1598183774 | Harry D. Burger | Dentist | 567 Bartson Rd., Fremont, OH 43420 | 2014-04-03 |
| 1750706636 | Lori Fisher | Registered Nurse | 500 W. State St., Suite A, Fremont, OH 43420 | 2014-02-28 |
| 1699113001 | Cora Renea Minich | Massage Therapist | 510 Court Street, Fremont, OH 43420 | 2013-06-07 |
| 1477850071 | Parschauer Eye Center Inc | Eyewear Supplier (Equipment, not the service) | 126 S. Front St, Fremont, OH 43420 | 2011-02-16 |
| 1316260839 | Marla D Carlisle | Physician Assistant | 605 Third Avenue, Suite B, Fremont, OH 43420 | 2010-03-11 |
| Find all providers in zip 43420 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609256411 | Harpreet Singh | Family Medicine | 39210 State St Ste 209, Fremont, CA 94538-1456 | 2015-06-05 |
| 1255727293 | Nicholas Andrew Phillips | Family Medicine | 556 Mowry Ave Ste 200, Fremont, CA 94536 | 2015-04-07 |
| 1245647908 | Temazcal Family Clinic | Family Medicine | 39277 Liberty St Bldg D, Fremont, CA 94538-1519 | 2014-07-15 |
| 1417395633 | Bonnie Huang Hall | Family Medicine | 46923 Warm Springs Blvd Ste 207, Fremont, CA 94539-7977 | 2013-06-10 |
| 1730401274 | Sveltlana Peng Burkhead | Family Medicine | 4041 Lowry Rd, Fremont, CA 94555-1101 | 2010-02-25 |
| 1003145103 | Deepti Saxena Md Inc | Family Medicine | 43628 Skye Rd, Fremont, CA 94539-5925 | 2009-12-18 |
| 1508088279 | Washington Family Health Medical Group, Inc. | Family Medicine | 38069 Martha Avenue, Siute 300, Fremont, CA 94536 | 2007-05-03 |
| 1275691222 | Tamara Cheney | Family Medicine | 2287 Mowry Ave Ste C, Fremont, CA 94538-1622 | 2006-12-04 |
| 1720199342 | Khalid A Baig | Family Medicine | 632 Mowry Ave, Fremont, CA 94536-4113 | 2006-08-31 |
| 1225146970 | Washington Newark Medical Group | Family Medicine | 46690 Mohave Dr, Fremont, CA 94539-7001 | 2006-08-25 |
| Find all providers in FREMONT | ||||
Please comment or provide details below to improve the information on MARY WONDERLY MD LLC.
| 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.