Healthcare Provider Details

I. General information

NPI: 1710088471
Provider Name (Legal Business Name): MUHANNAD HEIF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/03/2023
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3439 GRANITE CIR
TOLEDO OH
43617-1161
US

IV. Provider business mailing address

3439 GRANITE CIR
TOLEDO OH
43617-1161
US

V. Phone/Fax

Practice location:
  • Phone: 419-843-7996
  • Fax: 419-841-7725
Mailing address:
  • Phone: 419-843-7996
  • Fax: 419-841-7725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35099322
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberE3533
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number35099322
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: