Provider Demographics
NPI:1750084182
Name:MOYEED, MASHRUR (MD)
Entity type:Individual
Prefix:DR
First Name:MASHRUR
Middle Name:
Last Name:MOYEED
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 1:2200 JEFFERSON AVE
Mailing Address - Street 2:FAMILY MEDICINE RESIDENCY OFFICE
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604
Mailing Address - Country:US
Mailing Address - Phone:429-241-1400
Mailing Address - Fax:429-251-1797
Practice Address - Street 1:2200 JEFFERSON AVE
Practice Address - Street 2:MERCY FAMILY PHYSICIANS
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604
Practice Address - Country:US
Practice Address - Phone:419-241-1400
Practice Address - Fax:419-251-1797
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program