Provider Demographics
NPI:1396907283
Name:WEST TOLEDO OB-GYN ASSOCIATES INC.
Entity type:Organization
Organization Name:WEST TOLEDO OB-GYN ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-352-1519
Mailing Address - Street 1:3278 HIDDEN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9650
Mailing Address - Country:US
Mailing Address - Phone:419-352-1519
Mailing Address - Fax:419-352-7004
Practice Address - Street 1:4853 MONROE ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4384
Practice Address - Country:US
Practice Address - Phone:419-352-1519
Practice Address - Fax:419-352-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050010207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty