Provider Demographics
NPI:1366446635
Name:MONROE, TODD L (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:L
Last Name:MONROE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 N MCCORD RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1753
Mailing Address - Country:US
Mailing Address - Phone:419-842-3000
Mailing Address - Fax:419-842-3048
Practice Address - Street 1:2940 N MCCORD RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1753
Practice Address - Country:US
Practice Address - Phone:419-842-3000
Practice Address - Fax:419-842-3048
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064817207RC0000X, 207RI0011X
OH35059941M207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00711879OtherRRMC
OH0914292Medicaid
OH4010858Medicare PIN
OH0737915Medicare PIN
OH4103893Medicare PIN
OH7199231Medicare PIN
OH0914292Medicaid
OH110083177Medicare PIN
OH110085495Medicare PIN
OH4010854Medicare PIN
OH4103897Medicare PIN
P00711879OtherRRMC
OH4010856Medicare PIN
OH4103892Medicare PIN
OH4103896Medicare PIN
OH4103894Medicare PIN
OHMO4103898Medicare PIN
MIMI1635016Medicare PIN
MI0N23450Medicare PIN
C78322Medicare UPIN
OH4103895Medicare PIN
OH4010853Medicare PIN
OH0737918Medicare PIN
OK0737917Medicare PIN