MEDICARE: MAUMEE BAY FOOT & ANKLE AT TOLEDO LLC

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	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1447631148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAUMEE BAY FOOT & ANKLE AT TOLEDO LLC

Provider Business Mailing Address
First Line	:	609 MAIN ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-1745
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 MAIN ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-1745
Country	:	US
Telephone Number	:	419-691-1599
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	RACHEL MORRIS
Credential	:
Telephone Number	:	419-691-1599

Provider Enumeration Date	:	06/18/2015
Last Update Date	:	06/18/2015

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