Purisima, Mary Grace
Purisima, Mary Grace is an individual health care provider with primary practice located at 5105 Som Center Rd , Willoughby OH 44094-4203. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Purisima, Mary Grace can be contacted via phone (216) 524-7377.Contact Information
Primary practice address
5105 Som Center Rd
Willoughby OH 44094-4203
Phone: (216) 524-7377
Fax: (440) 975-4617
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35-069057 | Ohio |
Profile Details
| NPI number | 1003916479 |
|---|---|
| LBN Legal business name | Purisima, Mary Grace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Oct 9th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003916479 | NPPES |
| Ohio | MEDICAID | 0207038 |
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