Organization
MAUMEE VALLEY INTERNIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THURAI Y KUMARAN M.D. (PRESIDENT)
(419) 352-2105
Entity
Organization
Contact information
Practice address
960 W WOOSTER ST STE 205, BOWLING GREEN, OH 43402-2650
(419) 352-2105
Mailing address
960 W WOOSTER ST STE 205, BOWLING GREEN, OH 43402-2650
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
07353898
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2053745
—
OH
Enumeration date
02/10/2012
Last updated
02/10/2012
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