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Individual

JOHN CALVIN BOTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5757 MONCLOVA RD, STE 26, MAUMEE, OH 43537-1863
(419) 893-5557
(419) 893-5199
Mailing address
5757 MONCLOVA RD, STE 26, MAUMEE, OH 43537-1863
(419) 893-5557
(419) 893-5199

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34005250B
OH
207QG0300X
Geriatric Medicine (Family Medicine) Physician
34005250B
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0877154
OH
Enumeration date
06/28/2005
Last updated
01/27/2009
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