MEDICARE: INTELLECTUALS HEALTH & WELLNESS

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1942163860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTELLECTUALS HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	4410 LEWIS AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-1846
Country	:	US
Telephone Number	:	419-514-4265
Fax Number	:	419-725-0001

Provider Business Practice Location Address
First Line	:	4410 LEWIS AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-1846
Country	:	US
Telephone Number	:	419-514-4265
Fax Number	:	419-725-0001

Authorized Official
Title or Position	:	OWNER
Name	:	SHADAMA HOWARD
Credential	:
Telephone Number	:	419-514-4265

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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