Crisologo, Guillermo V

Crisologo, Guillermo V is an sole proprietor health care provider with primary practice located at 620 Jefferson St , Port Clinton OH 43452-2413. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Crisologo, Guillermo V can be contacted via phone (419) 734-3116.

Contact Information

Primary practice address
620 Jefferson St Port Clinton OH 43452-2413
Phone: (419) 734-3116
Fax: (419) 734-5786
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 35-032803 Ohio

Profile Details

NPI number 1821106295
LBN Legal business name Crisologo, Guillermo V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 27th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821106295 NPPES
Ohio Other 25500 ANTHEM BCBS OF OHIO
Ohio MEDICAID 0157397 ANTHEM BCBS OF OHIO

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