NPIMap

Organization Active NPI

Promedica Central Physicians, LLC

Doing business as Fadia Abaza, MD

  • Pediatrics Physician
  • Maumee, OH
National Provider Identifier
1295879716
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PROMEDICA CENTRAL PHYSICIANS, LLC
Doing business as
Fadia Abaza, MD
Practice address
650 Beaver Creek Cir
Suite 130
Maumee, OH 43537-1734
Phone
(419) 891-6262
Fax
(419) 893-1196
NPI assigned
Feb 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenya Dixon
Title
Credentialing Assistant
Phone
(419) 824-7288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

650 Beaver Creek Cir
Suite 130
Maumee, OH 43537-1734

Mailing address

650 Beaver Creek Cir
Suite 130
Maumee, OH 43537-1734
Phone (419) 891-6262

Other names 1

  • Fadia Abaza, MD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Central Physi75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

650 Beaver Creek Cir
Ste 130
Maumee, OH 43537
Phone (419) 891-6210

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295879716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 BEAVER CREEK CIR",
            "address_2": "SUITE 130",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371734",
            "telephone_number": "419-891-6262",
            "fax_number": "419-893-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 BEAVER CREEK CIR",
            "address_2": "SUITE 130",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371734",
            "telephone_number": "419-891-6262",
            "fax_number": "419-893-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "KENYA",
        "authorized_official_title_or_position": "CREDENTIALING ASSISTANT",
        "authorized_official_telephone_number": "419-824-7288"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fadia Abaza, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.