Provider Demographics
NPI:1164040093
Name:PIHLBLAD, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PIHLBLAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39265 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4781
Mailing Address - Country:US
Mailing Address - Phone:440-320-4115
Mailing Address - Fax:
Practice Address - Street 1:39265 ARLINGTON DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4781
Practice Address - Country:US
Practice Address - Phone:440-320-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF06202664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily