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NPI Code Detail

MEDICARE: BASEL AWA PA

MEDICARE: BASEL AWA PA
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
1363AM0700XMedical Physician Assistant50001145OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326045873
Entity Type Code : Individual
Provider Name (Legal Business Name) : BASEL AWA PA
Provider Business Mailing Address
First Line : 2142 N COVE BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43606-3895
Country : US
Telephone Number : 419-291-5318
Fax Number : 419-291-6430
Provider Business Practice Location Address
First Line : 2142 N COVE BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43606-3895
Country : US
Telephone Number : 419-291-5318
Fax Number : 419-291-6430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 11/03/2023

Similar Medicare Providers

1306793641 — HALEY ALEXIS SCHROEDER RN
Practice Location Address:
2142 N COVE BLVD
TOLEDO, OH
43606-3895
Practice Phone: 419-291-4000
Practice Fax:
1336745942 — CHRISTOPHER SIMMONS CRNA
Practice Location Address:
2142 N COVE BLVD
TOLEDO, OH
43606-3895
Practice Phone: 419-291-4491
Practice Fax: 419-479-6905
1396741054 — MICHAEL EUGENE RUHLEN M.D.
Practice Location Address:
2142 N COVE BLVD
TOLEDO, OH
43606-3895
Practice Phone: 419-291-8550
Practice Fax: 419-479-6992
1326045964 — KARL S DELUGA M.D.
Practice Location Address:
2142 N COVE BLVD
TOLEDO, OH
43606-3895
Practice Phone: 419-291-4225
Practice Fax: 419-479-6193
1629075171 — LAURA M O'LEARY PA
Practice Location Address:
2142 N COVE BLVD
TOLEDO, OH
43606-3895
Practice Phone: 419-291-5318
Practice Fax: 419-291-6430
1083611420 — BRIAN S BRADLEY M.D.
Practice Location Address:
2142 N COVE BLVD
TOLEDO, OH
43606-3895
Practice Phone: 419-291-4225
Practice Fax: 419-479-6193

Directions to “ BASEL AWA PA” Practice Location

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