| Mn Angels Clinic | |
|
4405 N Holland Sylvania Rd Ste 104 Toledo OH 43623-3533 | |
| (419) 882-6784 | |
| (419) 882-4795 |
| Full Name | Mn Angels Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 4405 N Holland Sylvania Rd Ste 104, Toledo, Ohio |
| Authorized Official Name and Position | Georges Jabaly (OWNER) |
| Authorized Official Contact | 4198826784 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mn Angels Clinic 4405 N Holland Sylvania Rd Ste 104 Toledo OH 43623-3533 Ph: (419) 882-6784 | Mn Angels Clinic 4405 N Holland Sylvania Rd Ste 104 Toledo OH 43623-3533 Ph: (419) 882-6784 |
| NPI Number | 1144346040 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 09/12/2014 |
| Medicare PECOS PAC ID | 7012991474 |
|---|---|
| Medicare Enrollment ID | O20040615000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144346040 | NPI | - | NPPES |
| 2878917 | Medicaid | OH | |
| DD6491 | Other | OH | RAILROAD MEDICARE |
| 000000322152 | Other | OH | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Georges T Jabaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407827074 PECOS PAC ID: 5092799320 Enrollment ID: I20040616000389 |
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