Provider Demographics
NPI:1205800414
Name:POHLOD, SUSAN ANN (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ANN
Last Name:POHLOD
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 1:3000 REGENCY CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3092
Mailing Address - Country:US
Mailing Address - Phone:419-841-7190
Mailing Address - Fax:419-841-9631
Practice Address - Street 1:3000 REGENCY CT
Practice Address - Street 2:SUITE 201
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3092
Practice Address - Country:US
Practice Address - Phone:419-841-7190
Practice Address - Fax:419-841-9631
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079037P174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2242988Medicaid
OHH38723Medicare UPIN
OH2242988Medicaid