Healthcare Provider Details

I. General information

NPI: 1093716953
Provider Name (Legal Business Name): YASMIN PARVEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 BIRCHARD AVE
FREMONT OH
43420-2967
US

IV. Provider business mailing address

396 RUTLEDGE CT
PERRYSBURG OH
43551-5201
US

V. Phone/Fax

Practice location:
  • Phone: 419-334-3869
  • Fax: 419-334-8619
Mailing address:
  • Phone: 419-872-3466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35077204
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: