Healthcare Provider Details

I. General information

NPI: 1821267451
Provider Name (Legal Business Name): DR. WINDER AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1479 N RIVER RD
FREMONT OH
43420-9760
US

IV. Provider business mailing address

5860 ALEXIS RD STE B
SYLVANIA OH
43560-2347
US

V. Phone/Fax

Practice location:
  • Phone: 419-355-8960
  • Fax: 419-885-4493
Mailing address:
  • Phone: 419-885-5755
  • Fax: 419-885-4493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number35-04-1807-W
License Number StateOH

VIII. Authorized Official

Name: MRS. SHARALEA D WOLFRAM
Title or Position: MEDICAL BILLER
Credential:
Phone: 419-885-5755