Provider Demographics
NPI:1215297049
Name:KOEHL, ANAMARIA CHACIN (MD)
Entity type:Individual
Prefix:
First Name:ANAMARIA
Middle Name:CHACIN
Last Name:KOEHL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:MARIA
Other - Last Name:CHACIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 JEFFERSON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2213 CHERRY ST FL 6
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2603
Practice Address - Country:US
Practice Address - Phone:419-251-3232
Practice Address - Fax:419-251-3897
Is Sole Proprietor?:No
Enumeration Date:2012-05-27
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351362062080P0203X, 2080P0203X
FLME1246462080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0354431Medicaid