Provider Demographics
NPI:1124000815
Name:BHUMBRA, NASREEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:NASREEN
Middle Name:A
Last Name:BHUMBRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-7146
Mailing Address - Fax:419-383-2050
Practice Address - Street 1:2222 CHERRY ST
Practice Address - Street 2:STE 2300
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2673
Practice Address - Country:US
Practice Address - Phone:419-251-8065
Practice Address - Fax:419-251-7715
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350478662080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0538458Medicaid
A15619Medicare UPIN
OHBH0543383Medicare ID - Type Unspecified