Provider Demographics
NPI:1730961152
Name:SGM HEALTH SCREENING
Entity type:Organization
Organization Name:SGM HEALTH SCREENING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:234-288-2563
Mailing Address - Street 1:3094 W MARKET ST STE 242
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3624
Mailing Address - Country:US
Mailing Address - Phone:234-288-2563
Mailing Address - Fax:330-266-4423
Practice Address - Street 1:3094 W MARKET ST STE 242
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3624
Practice Address - Country:US
Practice Address - Phone:234-288-2563
Practice Address - Fax:330-266-4423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service