Healthcare Provider Details

I. General information

NPI: 1720177314
Provider Name (Legal Business Name): ENDOCRINE & DIABETES CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W CENTRAL AVE SUITE 100
TOLEDO OH
43606-3834
US

IV. Provider business mailing address

2100 W CENTRAL AVE SUITE 100
TOLEDO OH
43606-3834
US

V. Phone/Fax

Practice location:
  • Phone: 419-537-5111
  • Fax: 419-537-5131
Mailing address:
  • Phone: 419-537-5111
  • Fax: 419-537-5131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD A BEHAM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 419-537-5111