Provider Demographics
NPI:1316382260
Name:HAMOUDA, DANAE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANAE
Middle Name:MARIE
Last Name:HAMOUDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANAE
Other - Middle Name:MARIE
Other - Last Name:HORSTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2598
Mailing Address - Country:US
Mailing Address - Phone:419-383-3727
Mailing Address - Fax:419-383-6197
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:GRADUATE MEDICAL EDUCATION
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-230-9623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.134142207RH0003X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0302793Medicaid