1508869751 NPI number — DR. ABED E ALO MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508869751 NPI number — DR. ABED E ALO MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ALO

Provider First Name:

ABED

Provider Middle Name:

E

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1508869751

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/22/2024

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

4235 SECOR RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

TOLEDO

Provider Business Mailing Address State Name:

OH

Provider Business Mailing Address Postal Code:

43623

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

419-473-3561

Provider Business Mailing Address Fax Number:

419-291-2242

Provider First Line Business Practice Location Address:

3454 OAK ALLEY CT STE 202

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

TOLEDO

Provider Business Practice Location Address State Name:

OH

Provider Business Practice Location Address Postal Code:

43606-1370

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

419-214-3971

Provider Business Practice Location Address Fax Number:

419-214-3972

Provider Enumeration Date:

05/23/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208600000X , with the licence number:  35048384 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208C00000X , with the licence number: 35-04-8384A , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208C00000X , with the licence number: 35048384 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 00130 . This is a "PARAMOUNT" identifier . This identifiers is of the category "OTHER".
• Identifier: 4002325 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 600447 . This is a "BUCKEYE COMMUNITY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 000000223904 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
• Identifier: 0543620 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
• Identifier: 22099 . This is a "NATIONWIDE" identifier . This identifiers is of the category "OTHER".
• Identifier: 1400052 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 600447 . This is a "FAMILY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 6336184001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 104389638 . This is a "MICHIGAN MEDICAID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
• Identifier: 280001104 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".