Provider Demographics
NPI:1467635805
Name:TOLEDO SLEEP DISORDERS CENTER
Entity type:Organization
Organization Name:TOLEDO SLEEP DISORDERS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MIKHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-794-8200
Mailing Address - Street 1:1661 HOLLAND RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537
Mailing Address - Country:US
Mailing Address - Phone:419-794-8200
Mailing Address - Fax:419-724-1892
Practice Address - Street 1:2702 NAVARRE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3223
Practice Address - Country:US
Practice Address - Phone:419-693-9727
Practice Address - Fax:419-693-9737
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOLEDO SLEEP DISORDERS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9320632Medicare PIN