Provider Demographics
NPI:1821030750
Name:MISTRY, ARVINDKUMAR H (MD)
Entity Type:Individual
Prefix:
First Name:ARVINDKUMAR
Middle Name:H
Last Name:MISTRY
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 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4231
Mailing Address - Country:US
Mailing Address - Phone:419-947-9532
Mailing Address - Fax:419-479-5593
Practice Address - Street 1:2600 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3207
Practice Address - Country:US
Practice Address - Phone:419-696-7701
Practice Address - Fax:419-696-7866
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35052484207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1939500-10Medicaid
OH000000130435OtherBCBS
OH0605787Medicaid
OHA16244Medicare UPIN
OHH093191Medicare PIN
OH050015895Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MI1939500-10Medicaid