Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 35080018 | OH |
NPI | 1003808825 |
---|---|
Provider Name | Erica Pribis |
First Address | Defiance, OH 43512-1396 |
Second Address | Oregon, OH 43616-4920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 13/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000329023 | ANTHEM (01) | OH |
000000550254 | ANTHEM (01) | OH |
2317648 | (05) | OH |
H60118 | (02) |