Healthcare Provider Details

I. General information

NPI: 1306849146
Provider Name (Legal Business Name): MICHAEL L KUEHNE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2190 HUGHES DR STE 720
TOLEDO OH
43606-3831
US

IV. Provider business mailing address

2109 HUGHES DR STE 720
TOLEDO OH
43606-3856
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-2077
  • Fax: 419-291-2122
Mailing address:
  • Phone: 419-291-2077
  • Fax: 419-291-2122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number50001062
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: