Healthcare Provider Details

I. General information

NPI: 1235304478
Provider Name (Legal Business Name): SAUDIA MUSHKBAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 N HOLLAND SYLVANIA RD STE C
TOLEDO OH
43623-3522
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4231
US

V. Phone/Fax

Practice location:
  • Phone: 419-517-7687
  • Fax:
Mailing address:
  • Phone: 419-473-3561
  • Fax: 419-473-3561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.098083
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01064793A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35098083
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: