Monclova Road Pediatrics
Pediatrics in Maumee, OH. Organization (NPI-2).
NPI number1679901649
StatusActive
Last updated in NPPESSep 18, 2024
Details
- NPI
- 1679901649
- Entity type
- Organization (NPI-2)
- Legal business name
- Monclova Road Pediatrics
- Organization subpart
- No
- Enumeration date
- Oct 29, 2013
- Certification date
- Sep 18, 2024
- Last updated
- Sep 18, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | OH | Yes |
Practice location
5757 Monclova Rd Ste 10Maumee, OH 43537-1863
Phone 419-887-0803 · Fax 419-887-0817
Mailing address
5757 Monclova Rd Ste 10Maumee, OH 43537-1863
Phone 419-887-0803 · Fax 419-887-0817
Authorized official
Kathryn R Davis
Owner
4198870803
Is something wrong?
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