Healthcare Provider Details

I. General information

NPI: 1548267248
Provider Name (Legal Business Name): MALINI SATISH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 N COVE BLVD
TOLEDO OH
43606-3895
US

IV. Provider business mailing address

2326 PLUM LEAF LN
TOLEDO OH
43614-1141
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-4225
  • Fax: 419-479-6193
Mailing address:
  • Phone: 419-866-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number45150
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: