Basic Information
| Provider Information | |||||||||
| NPI: | 1235304478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUSHKBAR | ||||||||
| FirstName: | SAUDIA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4235 SECOR RD | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436234231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194733561 | ||||||||
| FaxNumber: | 4194733561 | ||||||||
| Practice Location | |||||||||
| Address1: | 6005 MONCLOVA RD | ||||||||
| Address2: | |||||||||
| City: | MAUMEE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435371864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193835522 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2008 | ||||||||
| LastUpdateDate: | 06/16/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 01064793A | IN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 35.098083 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | 35098083 | OH | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.