Healthcare Provider Details

I. General information

NPI: 1871978411
Provider Name (Legal Business Name): ANJUM MAGSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 SUNFOREST CT STE 105
TOLEDO OH
43623-4473
US

IV. Provider business mailing address

3949 SUNFOREST CT STE 105
TOLEDO OH
43623-4473
US

V. Phone/Fax

Practice location:
  • Phone: 419-475-9341
  • Fax: 419-474-0095
Mailing address:
  • Phone: 419-475-9341
  • Fax: 419-474-0095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.17865
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.394540
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: