Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 35056648 | OH |
N | 207R00000X | Internist | 35056648 | OH |
N | 111NI0900X | Internist | 35056648 | OH |
NPI | 1265429526 |
---|---|
Provider Name | Mrs. Elloise Carol Gard |
First Address | Toledo, OH 43609-1910 |
Second Address | Perrysburg, OH 43551-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 26/02/2020 |