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NPI Code Detail

MEDICARE: MAMLE ANIM MD

MEDICARE: MAMLE ANIM MD
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
1207R00000XInternal Medicine Physician35371306OH

Other Identifiers

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

General Provider Information

NPI Number : 1790741536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAMLE ANIM MD
Provider Business Mailing Address
First Line : 725 UNIVERSITY BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45435-0001
Country : US
Telephone Number : 937-245-7100
Fax Number : 937-245-7999
Provider Business Practice Location Address
First Line : 721 MIAMI CHAPEL RD
Second Line :
City : DAYTON
State : OH
Zip : 45417-4650
Country : US
Telephone Number : 937-281-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2006
Last Update Date : 08/26/2022

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Directions to “ MAMLE ANIM MD” Practice Location

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