Basic Information
Provider Information
NPI: 1760801476
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAWFIK
FirstName: REEM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3355 GLENDALE AVE
Address2: 3RD FLOOR
City: TOLEDO
State: OH
PostalCode: 436142426
CountryCode: US
TelephoneNumber: 4193837100
FaxNumber: 4193832000
Practice Location
Address1: 3333 GLENDALE AVE
Address2:  
City: TOLEDO
State: OH
PostalCode: 436142426
CountryCode: US
TelephoneNumber: 4193835555
FaxNumber: 4193833113
Other Information
ProviderEnumerationDate: 04/09/2014
LastUpdateDate: 10/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X35.129695OHY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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