MEDICARE: MAHDI NICOLA DOUMET 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
1	207RA0401X	Addiction Medicine (Internal Medicine) Physician	35.067558	OH
2	207R00000X	Internal Medicine Physician	35067558	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	:	1801880471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHDI NICOLA DOUMET MD

Provider Business Mailing Address
First Line	:	4235 SECOR RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4231
Country	:	US
Telephone Number	:	419-473-3561
Fax Number	:

Provider Business Practice Location Address
First Line	:	6855 SPRING VALLEY DR
Second Line	:	#120
City	:	HOLLAND
State	:	OH
Zip	:	43528-8039
Country	:	US
Telephone Number	:	419-865-3111
Fax Number	:

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	11/03/2023

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