Provider Demographics
NPI:1619979705
Name:MAAIEH, MOHAMMED M (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:M
Last Name:MAAIEH
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:419-842-3042
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:419-842-3042
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
MI4301084912207RC0000X
OH35076398M207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2123320Medicaid
OHPO0952649OtherRRMC
P00711906OtherRRMC
OHMA4257721Medicare PIN
OH4134492Medicare PIN
MIMI1635002Medicare PIN
OH0884127Medicare PIN
G98900Medicare UPIN
OH4134488Medicare PIN
MI0N23450Medicare PIN
OH41344482Medicare PIN
OH4134485Medicare PIN
OH4134489Medicare PIN
OHCF7396Medicare PIN
OH00103897Medicare PIN
OH4134491Medicare PIN
MICF8513Medicare PIN
OH0884128Medicare PIN
OHG98900Medicare UPIN
OH0884129Medicare PIN
OH2123320Medicaid
OH4134486Medicare PIN
MICK5518Medicare PIN
MI23450024Medicare PIN