Healthcare Provider Details

I. General information

NPI: 1376860791
Provider Name (Legal Business Name): MARIAM MILAD MINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2010
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 REGENCY CT STE 200
TOLEDO OH
43623-3074
US

IV. Provider business mailing address

3000 ARLINGTON AVE STOP 118
TOLEDO OH
43614-2595
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-2450
  • Fax: 419-479-2639
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.120082
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number35.120082
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: