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General NPI Number Information
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NPI Number | 1114193653
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY WELLNESS OF TOLEDO LLC
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 4417 N HOLLAND SYLVANIA RD SUITE 301
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City | TOLEDO
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State | OH
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Zip | 43623-3518
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Country | US
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Telephone | 419-842-1100
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Fax | 419-842-1119
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Provider Business Mailing Address
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Address Line | PO BOX 1331
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City | TOLEDO
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State | OH
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Zip | 43603-1331
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Country | US
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Telephone | 419-842-1100
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Fax | 419-842-1119
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Authorized Official
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Title or Position | OWNER
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Name | JEFFERY C. MALUDY
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Credential | MD
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Telephone | 419-842-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 3504885773
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License Number State | OH
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