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FALLEN TIMBERS INTERNAL MEDICINE, LLC
NPI 1205986247
Internal Medicine in Maumee, OH

Active since January 11, 2007CLIA 36D0988755 · Waiver
6450 WHEATSTONE CT, MAUMEE, OH 43537(419) 866-6200(419) 866-7170 Get Directions Write a Review

NPPES record last updated: November 14, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fallen Timbers Internal Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FALLEN TIMBERS INTERNAL MEDICINE, LLC (NPI 1205986247) is a healthcare organization registered as an internal medicine in Maumee, Ohio and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through July 8, 2027 and lists Nizar Y Daboul, Owner President, as its authorized official.

NPPES Registry Identity

NPI1205986247
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameFALLEN TIMBERS INTERNAL MEDICINE, LLC
Location Address6450 WHEATSTONE CTMaumee, OH 43537-9402
Mailing Address6450 Wheatstone CtMaumee, OH 43537-9402 · (419) 866-6200 · Fax (419) 866-7170
Phone(419) 866-6200
Fax(419) 866-7170
Organization SubpartNo
Authorized OfficialNizar Y DaboulOwner President · (419) 866-6200
Enumeration DateJanuary 11, 2007
Last NPPES UpdateNovember 14, 2007
✔ NPI 1205986247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OH · 35072198
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
6450 WHEATSTONE CT, Maumee, OH 43537
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Other Identifiers 6

Medicare UPING44901OH
Medicare UPINI49972OH
Medicare ID-Type Unspecified9325321OH
Medicaid2633396OH
Medicare ID-Type Unspecified4178501OH
Medicaid2008562OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D0988755

Fallen Timbers Internal Medicine LLC · Maumee, OH
Active · expires Jul 8, 2027
CLIA Number36D0988755
Laboratory TypePhysician Office
Certificate Effective DateJuly 9, 2025
Certificate Expiration DateJuly 8, 2027
Laboratory DirectorNizar Y. Daboul MD
Laboratory Phone(419) 897-9980
Laboratory LocationFallen Timbers Internal Medicine LLC6450 Wheatstone Ct, Maumee, OH 43537
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSANDRA JUNE KAISER-BARROW APRN, FNP-C
Nurse Practitioner
6450 WHEATSTONE CT
MAUMEE, OH 43537
Lucas County (419) 866-6200
DR. NIDAA KHAMOUSIA M.D.
Internal Medicine
6450 WHEATSTONE CT
MAUMEE, OH 43537
Lucas County (419) 866-6200
DR. NIZAR Y DABOUL M.D
Internal Medicine
6450 WHEATSTONE CT
MAUMEE, OH 43537
Lucas County (419) 866-6200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fallen Timbers Internal Medicine, LLC's NPI number?

The NPI number for Fallen Timbers Internal Medicine, LLC is 1205986247. It was assigned to this organization in the NPPES registry on January 11, 2007.

Where is Fallen Timbers Internal Medicine, LLC located?

Fallen Timbers Internal Medicine, LLC is located at 6450 Wheatstone Ct, Maumee, OH 43537. The listed phone number is (419) 866-6200.

What is Fallen Timbers Internal Medicine, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Fallen Timbers Internal Medicine, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0988755) is associated with this NPI, valid through July 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fallen Timbers Internal Medicine, LLC was last updated on November 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.