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General NPI Number Information
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NPI Number | 1700842796
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Entity Type | Organization
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Legal Business Name | TOLEDO CLINIC PLLC
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 7301 SECOR RD
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-9737
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Country | US
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Telephone | 419-479-5795
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Fax | 419-479-5797
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Provider Business Mailing Address
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Address Line | 4235 SECOR RD
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City | TOLEDO
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State | OH
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Zip | 43623
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | AMBER D PENIX
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Credential |
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Telephone | 419-214-4214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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