| Fallen Timbers Internal Medicine, Llc | |
|
6450 Wheatstone Ct Maumee OH 43537-9402 | |
| (419) 866-6200 | |
| (419) 866-7170 |
| Full Name | Fallen Timbers Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6450 Wheatstone Ct, Maumee, Ohio |
| Authorized Official Name and Position | Nizar Y Daboul (OWNER PRESIDENT) |
| Authorized Official Contact | 4198666200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fallen Timbers Internal Medicine, Llc 6450 Wheatstone Ct Maumee OH 43537-9402 Ph: (419) 866-6200 | Fallen Timbers Internal Medicine, Llc 6450 Wheatstone Ct Maumee OH 43537-9402 Ph: (419) 866-6200 |
| NPI Number | 1205986247 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 11/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205986247 | NPI | - | NPPES |
| 2008562 | Medicaid | OH | |
| 2633396 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35072198 (Ohio) | Primary |
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