Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 3556689 | OH |
NPI | 1013912096 |
---|---|
Provider Name | Eric A Pizza |
First Address | Toledo, OH 43606-1319 |
Second Address | Toledo, OH 43606-1319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 03/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0706589 | (05) | OH |
340011839 | RAILROAD MEDICARE (01) | OH |
A17478 | (02) |