Potoczak, Douglas J

Potoczak, Douglas J is an individual health care provider with primary practice located at 6115 Emerald St , N Ridgeville OH 44039-2047. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Potoczak, Douglas J can be contacted via phone (440) 406-5800.

Contact Information

Primary practice address
6115 Emerald St N Ridgeville OH 44039-2047
Phone: (440) 406-5800
Fax: (216) 201-6914
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35060432 Ohio

Profile Details

NPI number 1710190046
LBN Legal business name Potoczak, Douglas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2007
Last updated Dec 17th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710190046 NPPES
Ohio MEDICAID 3025372
Ohio MEDICAID 0897874

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