MEDICARE: TIBERIU AVRAM MD PC

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	207V00000X	Obstetrics & Gynecology Physician	35.087285	OH

General Provider Information

NPI Number	:	1700336583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIBERIU AVRAM MD PC

Provider Business Mailing Address
First Line	:	3020 N MCCORD RD
Second Line	:	SUITE 201A
City	:	TOLEDO
State	:	OH
Zip	:	43615-1744
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 N MCCORD RD
Second Line	:	SUITE 201A
City	:	TOLEDO
State	:	OH
Zip	:	43615-1744
Country	:	US
Telephone Number	:	419-450-0045
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TIBERIU AVRAM
Credential	:	M.D.
Telephone Number	:	419-450-0045

Provider Enumeration Date	:	10/05/2016
Last Update Date	:	01/25/2017

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