MEDICARE: IDREES MOHIUDDIN 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	207R00000X	Internal Medicine Physician	MC-1775	ID
2	207R00000X	Internal Medicine Physician	35.131108	OH
3	207R00000X	Internal Medicine Physician	65360	TN
4	207R00000X	Internal Medicine Physician	72483	MN
5	208M00000X	Hospitalist Physician	35.131108	OH

General Provider Information

NPI Number	:	1518372713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IDREES MOHIUDDIN M.D.

Provider Business Mailing Address
First Line	:	3000 ARLINGTON AVE STOP 1108
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2595
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 ARLINGTON AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2595
Country	:	US
Telephone Number	:	419-383-3829
Fax Number	:	419-383-3058

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

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	04/07/2026

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