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General NPI Number Information
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NPI Number | 1801880471
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Entity Type | Individual
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Provider Name | MAHDI NICOLA DOUMET MD
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Gender | Male
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 6855 SPRING VALLEY DR #120
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City | HOLLAND
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State | OH
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Zip | 43528-8039
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Country | US
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Telephone | 419-865-3111
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Fax |
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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 | 43623-4231
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Country | US
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Telephone | 419-473-3561
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 35.067558
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35067558
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License Number State | OH
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