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NPI Code Detail

MEDICARE: ESTELA MIQUIABAS, MD

MEDICARE: ESTELA MIQUIABAS, MD
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
1174400000XSpecialist

General Provider Information

NPI Number : 1417918251
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESTELA MIQUIABAS, MD
Provider Business Mailing Address
First Line : 725 S SHOOP AVE
Second Line :
City : WAUSEON
State : OH
Zip : 43567-1702
Country : US
Telephone Number : 419-335-2015
Fax Number :
Provider Business Practice Location Address
First Line : 725 S SHOOP AVE
Second Line :
City : WAUSEON
State : OH
Zip : 43567-1702
Country : US
Telephone Number : 419-335-2015
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ESTELA MIQUIABAS
Credential : MD
Telephone Number : 419-335-3038
Provider Enumeration Date : 03/31/2006
Last Update Date : 08/22/2020

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Directions to “ESTELA MIQUIABAS, MD ” Practice Location

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