MEDICARE: ADAM T MIERZWA 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	208D00000X	General Practice Physician	35.146520	OH
2	2084N0400X	Neurology Physician	35.146520	OH

General Provider Information

NPI Number	:	1811525272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM T MIERZWA MD

Provider Business Mailing Address
First Line	:	2130 W CENTRAL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3818
Country	:	US
Telephone Number	:	419-291-3900
Fax Number	:	419-291-3900

Provider Business Practice Location Address
First Line	:	2130 W CENTRAL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3818
Country	:	US
Telephone Number	:	419-291-7623
Fax Number	:

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

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	01/08/2025

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