MAUMEE BAY FAMILY PRACTICE INC. NPI 1952403776

NPI Information

NPI: 1952403776
Provider Name: MAUMEE BAY FAMILY PRACTICE, INC.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 36D0957698

Address:
4330 NAVARRE AVE
SUITE 103
OREGON, OH
ZIP 43616
Phone: (419) 691-7820
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MAUMEE BAY FAMILY PRACTICE, INC. is a primary care clinic center in Oregon, OH. MAUMEE BAY FAMILY PRACTICE, INC. NPI is 1952403776. The provider is registered as an organization entity type.

The provider's business location address is:

4330 NAVARRE AVE
SUITE 103
OREGON, OH
ZIP 43616-578
Phone: (419) 691-7820
Fax: (419) 691-7593

The provider's authorized official is Tara S Robinson .
The authorized official title is President Owner and has the following contact phone number (419) 691-7820.

The CLIA number assigned to this NPI record is 36D0957698 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/2/2006 and was last updated on 4/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	35078608R	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H22080	MEDICARE UPIN	OHIO
2	CH2545	MEDICARE ID-TYPE UNSPECIFIED	OHIO	RAILROAD GROUP NUMBER
3	MA9310441	MEDICARE ID-TYPE UNSPECIFIED	OHIO	GROUP NUMBER
4	2343128	MEDICAID	OHIO
5	724392	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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