MEDICARE: MICHAEL HUBBARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	400542391006	OH

General Provider Information

NPI Number	:	1013321595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HUBBARD

Provider Business Mailing Address
First Line	:	1305 N WESTHAVEN RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-4777
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1305 N WESTHAVEN RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-4777
Country	:	US
Telephone Number	:	419-705-6970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2014
Last Update Date	:	06/12/2014

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Directions to “ MICHAEL HUBBARD ” Practice Location

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