Individual
ANTOINETTE L MEDAGLIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
660 BEAVER CREEK CIR, SUITE 100, MAUMEE, OH 43537-1745
(419) 891-6221
(419) 893-3394
Mailing address
660 BEAVER CREEK CIR, SUITE 100, MAUMEE, OH 43537-1745
(419) 891-6221
(419) 893-3394
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35064915
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141186
ANTHEM
OH
01
—
01549
PHC
OH
01
—
0636039
AETNA
OH
05
—
0937651
—
OH
01
—
12-01208
UHC
OH
Enumeration date
08/16/2005
Last updated
03/05/2013
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