MEDICARE: COMPREHENSIVE FAMILY PRACTICE

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	207Q00000X	Family Medicine Physician	34006654	OH

General Provider Information

NPI Number	:	1720145899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	4805 SUDER AVE
Second Line	:	SUITE A
City	:	TOLEDO
State	:	OH
Zip	:	43611-1800
Country	:	US
Telephone Number	:	419-726-1585
Fax Number	:	419-726-0381

Provider Business Practice Location Address
First Line	:	4805 SUDER AVE
Second Line	:	SUITE A
City	:	TOLEDO
State	:	OH
Zip	:	43611-1800
Country	:	US
Telephone Number	:	419-726-1585
Fax Number	:	419-726-0381

Authorized Official
Title or Position	:	VICE PRESIDENT AND SECRETARY
Name	:	DR. MICHAEL PRANAS NEVERAUSKAS
Credential	:	D.O
Telephone Number	:	419-726-1585

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	08/22/2020

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Directions to “COMPREHENSIVE FAMILY PRACTICE ” Practice Location

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