MEDICARE: DR. SUSAN ANN POHLOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	35079037P	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205800414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN ANN POHLOD M.D.

Provider Business Mailing Address
First Line	:	3000 REGENCY CT
Second Line	:	SUITE 201
City	:	TOLEDO
State	:	OH
Zip	:	43623-3092
Country	:	US
Telephone Number	:	419-841-7190
Fax Number	:	419-841-9631

Provider Business Practice Location Address
First Line	:	3000 REGENCY CT
Second Line	:	SUITE 201
City	:	TOLEDO
State	:	OH
Zip	:	43623-3092
Country	:	US
Telephone Number	:	419-841-7190
Fax Number	:	419-841-9631

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	01/26/2010

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