Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | SL302205 | OH |
NPI | 1063500932 |
---|---|
Provider Name | Dr. Andreas Herbert Syllaba |
First Address | Loveland, OH 45140-0330 |
Second Address | Loveland, OH 45140-7300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2259701 | (05) | OH |
F78873 | (02) | OH |