Gaddam, Eliyazar

Gaddam, Eliyazar is an sole proprietor health care provider with primary practice located at 951 Commerce Pkwy Suite 100, Lima OH 45804-4040. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Gaddam, Eliyazar can be contacted via phone (419) 224-5915.

Contact Information

Primary practice address
951 Commerce Pkwy Suite 100 Lima OH 45804-4040
Phone: (419) 224-5915
Fax: (419) 224-5918
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35.127156 Ohio
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036083544 Illinois

Profile Details

NPI number 1073561858
LBN Legal business name Gaddam, Eliyazar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2006
Last updated Aug 28th, 2020 - about 6 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 1073561858 NPPES
Wisconsin MEDICAID 1073561858
Wisconsin MEDICAID 036083544

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