MEDICARE: AYMAN AOUTHMANY 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
1	207R00000X	Internal Medicine Physician	35.147085	OH
2	207K00000X	Allergy & Immunology Physician	35.147085	OH

General Provider Information

NPI Number	:	1639668429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYMAN AOUTHMANY MD

Provider Business Mailing Address
First Line	:	PO BOX 38
Second Line	:
City	:	OTTAWA LAKE
State	:	MI
Zip	:	49267-0038
Country	:	US
Telephone Number	:	419-540-8556
Fax Number	:

Provider Business Practice Location Address
First Line	:	2735 NAVARRE AVE UNIT 203
Second Line	:
City	:	OREGON
State	:	OH
Zip	:	43616-3275
Country	:	US
Telephone Number	:	419-540-8556
Fax Number	:

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

Provider Enumeration Date	:	05/07/2018
Last Update Date	:	11/30/2023

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Directions to “ AYMAN AOUTHMANY MD” Practice Location

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