Organization
FALLEN TIMBERS INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIZAR Y DABOUL MD (OWNER PRESIDENT)
(419) 866-6200
Entity
Organization
Contact information
Practice address
6450 WHEATSTONE CT, MAUMEE, OH 43537-9402
(419) 866-6200
(419) 866-7170
Mailing address
6450 WHEATSTONE CT, MAUMEE, OH 43537-9402
(419) 866-6200
(419) 866-7170
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35072198
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008562
—
OH
05
—
2633396
—
OH
Enumeration date
01/11/2007
Last updated
11/14/2007
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