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General NPI Number Information
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NPI Number | 1871379834
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Entity Type | Organization
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Legal Business Name | ALLERGY AND IMMUNOLOGY CONSULTANTS LLC
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 2735 NAVARRE AVE UNIT 203
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City | OREGON
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State | OH
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Zip | 43616-3275
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Country | US
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Telephone | 419-540-8556
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 38
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City | OTTAWA LAKE
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State | MI
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Zip | 49267-0038
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Country | US
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Telephone | 419-540-8556
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | AYMAN AOUTHMANY
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Credential | MD
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Telephone | 419-540-8556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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