Provider Demographics
NPI:1215936125
Name:DARAH, GEORGE N (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:N
Last Name:DARAH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:419-843-8100
Mailing Address - Fax:419-841-4681
Practice Address - Street 1:5700 MONROE ST UNIT 203
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2735
Practice Address - Country:US
Practice Address - Phone:419-843-8100
Practice Address - Fax:419-841-4681
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35002752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01-05757OtherUHC
OH01145OtherPARAMOUNT
OH0439592Medicaid
OH08018174OtherRRMC
OH4072744OtherAETNA
OH000000298175OtherANTHEM
OH000000298175OtherANTHEM
OH08018174OtherRRMC
$$$$$$$$$-004OtherMMOH
OHDA0483796Medicare ID - Type Unspecified