Healthcare Provider Details

I. General information

NPI: 1992632889
Provider Name (Legal Business Name): MARIUM QIDWAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W. MARKET ST. MERCY HEALTH-ST RITA'S MEDICAL CENTER
LIMA OH
45801
US

IV. Provider business mailing address

730 W. MARKET ST. MERCY HEALTH-ST RITA'S MEDICAL CENTER
LIMA OH
45801
US

V. Phone/Fax

Practice location:
  • Phone: 419-235-4016
  • Fax:
Mailing address:
  • Phone: 419-235-4016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: