Healthcare Provider Details

I. General information

NPI: 1538473616
Provider Name (Legal Business Name): MOHAMMED ASHRAF PUTHIYACHIRAKKAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MOHAMMED ASHRAF PUTHIYACHIRAKKAL MD

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 CHERRY ST
TOLEDO OH
43608-2603
US

IV. Provider business mailing address

2213 CHERRY STREET
TOLEDO OH
43608
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-3232
  • Fax: 419-251-5117
Mailing address:
  • Phone: 419-251-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.126348
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: