Healthcare Provider Details

I. General information

NPI: 1477242741
Provider Name (Legal Business Name): HAFSA FATIMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 JEFFERSON AVE. MERCY FAMILY PHYSICIANS
TOLEDO OH
43604
US

IV. Provider business mailing address

2200 JEFFERSON AVE. FAMILY MEDICINE RESIDENCY OFFICE
TOLEDO OH
43604
US

V. Phone/Fax

Practice location:
  • Phone: 419-241-1400
  • Fax: 419-251-1797
Mailing address:
  • Phone: 419-241-1400
  • Fax: 419-251-1797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.156161
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: