Individual
DR. MAMON Y MAITEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4235 SECOR RD, TOLEDO, OH 43623-4231
(419) 479-5560
(419) 473-2065
Mailing address
4235 SECOR RD, TOLEDO, OH 43623
(419) 473-3561
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301079222
MI
2084N0400X
Neurology Physician
Primary
2007001624
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4746015
—
MI
Enumeration date
02/02/2006
Last updated
09/15/2010
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