Provider Demographics
NPI:1871090316
Name:INTEGRATED HEALTH MEDICAL CONSULTANTS LLC
Entity type:Organization
Organization Name:INTEGRATED HEALTH MEDICAL CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBROSIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-203-7252
Mailing Address - Street 1:4487 VILLAGE CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7156
Mailing Address - Country:US
Mailing Address - Phone:614-203-7252
Mailing Address - Fax:
Practice Address - Street 1:4487 VILLAGE CLUB DRIVE
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7156
Practice Address - Country:US
Practice Address - Phone:614-203-7252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty