Provider Demographics
NPI:1538473616
Name:PUTHIYACHIRAKKAL, MOHAMMED ASHRAF (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED ASHRAF
Middle Name:
Last Name:PUTHIYACHIRAKKAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:MOHAMMED ASHRAF
Other - Middle Name:
Other - Last Name:PUTHIYACHIRAKKAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2213 CHERRY STREET
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608
Mailing Address - Country:US
Mailing Address - Phone:419-251-3232
Mailing Address - Fax:
Practice Address - Street 1:2213 CHERRY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2603
Practice Address - Country:US
Practice Address - Phone:419-251-3232
Practice Address - Fax:419-251-5117
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1263482080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0140732Medicaid