Individual provider Active NPI

Michael Thomas Drewyor, PHD

  • Clinical Psychologist
  • Toledo, OH
National Provider Identifier
1497805469
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4747 Issued in OH
Practice address
3150 N Republic Blvd
Suite 5
Toledo, OH 43615-1524
Phone
(419) 841-6256
Fax
(419) 841-5924
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4747 OH Primary

Addresses

Primary practice location

3150 N Republic Blvd
Suite 5
Toledo, OH 43615-1524

Mailing address

3150 N Republic Blvd
Suite 5
Toledo, OH 43615-1524
Phone (419) 841-6256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315000508 OH Practitioner - Clinical Psychologist 8820987092 Practice locations: Maumee, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

429 W Dussel Dr
Maumee, OH 43537-4208
Phone (419) 794-0556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497805469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N REPUBLIC BLVD",
            "address_2": "SUITE 5",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151524",
            "telephone_number": "419-841-6256",
            "fax_number": "419-841-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N REPUBLIC BLVD",
            "address_2": "SUITE 5",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151524",
            "telephone_number": "419-841-6256",
            "fax_number": "419-841-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREWYOR",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.