Provider Demographics
NPI:1801841663
Name:IGNARSKI, TODD EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:EDWARD
Last Name:IGNARSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TODD
Other - Middle Name:E
Other - Last Name:IGNARSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1005 BELLEFONTAINE AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2851
Mailing Address - Country:US
Mailing Address - Phone:419-222-8432
Mailing Address - Fax:419-222-9057
Practice Address - Street 1:13067 N TELECOM PKWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-0926
Practice Address - Country:US
Practice Address - Phone:813-779-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME133711207Q00000X, 208M00000X
OH35076123I207Q00000X
CAC145040208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2145806Medicaid
OHIG9352001OtherMEDICARE GROUP NUMBER
OHIG0882984Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
H03597Medicare UPIN
OH2145806Medicaid