Basic Information
Provider Information | |||||||||
NPI: | 1003341496 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | WESTPHAL | ||||||||
FirstName: | NATHANIEL | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 333 N SUMMIT ST FL 7 | ||||||||
Address2: |   | ||||||||
City: | TOLEDO | ||||||||
State: | OH | ||||||||
PostalCode: | 436041531 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: |   | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2142 N COVE BOULEVARD | ||||||||
Address2: | DEPARTMENT OF ANESTHESIA TOLEDO CRITICAL CARE | ||||||||
City: | TOLEDO | ||||||||
State: | OH | ||||||||
PostalCode: | 43604 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4192911111 | ||||||||
FaxNumber: | 4194793253 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/24/2017 | ||||||||
LastUpdateDate: | 07/21/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 07/11/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X |   | NC | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   | 207RC0200X | 35.145725 | OH | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207P00000X | 227190 | NC | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   |
No ID Information.