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General NPI Number Information
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NPI Number | 1215023650
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Entity Type | Organization
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Legal Business Name | MAUMEE BAY OBSTETRICS & GYNECOLOGY INC P A
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 2702 NAVARRE AVE SUITE 305
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City | OREGON
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State | OH
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Zip | 43616-3223
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Country | US
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Telephone | 419-691-8000
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Fax | 419-693-0111
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Provider Business Mailing Address
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Address Line | 2702 NAVARRE AVE SUITE 305
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City | OREGON
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State | OH
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Zip | 43616-3223
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Country | US
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Telephone | 419-691-8000
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Fax | 419-693-0111
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | MITCHELL GORDON GREENBAUM
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Credential | D.O.
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Telephone | 419-691-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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