Provider Demographics
NPI:1558654020
Name:BIGELOW, NATALIE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1638 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-3240
Mailing Address - Country:US
Mailing Address - Phone:419-769-5132
Mailing Address - Fax:
Practice Address - Street 1:1638 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-3240
Practice Address - Country:US
Practice Address - Phone:567-661-0565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000050361207Q00000X
OH35.133520207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty