Provider Demographics
NPI:1871379834
Name:ALLERGY AND IMMUNOLOGY CONSULTANTS LLC
Entity type:Organization
Organization Name:ALLERGY AND IMMUNOLOGY CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AOUTHMANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-540-8556
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:OTTAWA LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49267-0038
Mailing Address - Country:US
Mailing Address - Phone:419-540-8556
Mailing Address - Fax:
Practice Address - Street 1:2735 NAVARRE AVE UNIT 203
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3275
Practice Address - Country:US
Practice Address - Phone:419-540-8556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty