Provider Demographics
NPI:1972802452
Name:AMAL EL TAJI
Entity Type:Organization
Organization Name:AMAL EL TAJI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ELTAJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-385-6457
Mailing Address - Street 1:3401 GLENDALE AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2490
Mailing Address - Country:US
Mailing Address - Phone:419-385-6457
Mailing Address - Fax:419-385-2555
Practice Address - Street 1:3401 GLENDALE AVE STE 212
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2490
Practice Address - Country:US
Practice Address - Phone:419-385-6457
Practice Address - Fax:419-385-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty