Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 1142 | OH |
NPI | 1417088212 |
---|---|
Provider Name | Dr. Nicholas John Hadzima |
First Address | Willoughby, OH 44094-6586 |
Second Address | Highland Heights, OH 44143-3106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T81995 | (02) | OH |