Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | TRN15225 | FL |
Y | 111NI0900X | Internist | TRN15225 | FL |
N | 207RR0500X | Rheumatology | 57.022470 | OH |
NPI | 1104132554 |
---|---|
Provider Name | Dr. Piyush Poddar |
First Address | Cleveland, OH 44195 |
Second Address | Cleveland, OH 44195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2010 |
Last Update Date | 09/01/2014 |