Organization
ALLIANCE RETINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GREGORY ROSENTHAL MD (PRESIDENT)
(419) 873-6800
Entity
Organization
Contact information
Practice address
5757 MONCLOVA RD STE 11, MAUMEE, OH 43537-1863
(419) 873-6800
(419) 873-6804
Mailing address
5757 MONCLOVA RD STE 11, MAUMEE, OH 43537-1863
(419) 356-4224
(419) 873-6804
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0749300
—
OH
Enumeration date
06/21/2013
Last updated
03/25/2020
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