| Elyria Internal Medicine, Inc | |
|
125 E Broad St Ste 202 Elyria OH 44035-6400 | |
| (440) 329-7306 | |
| (440) 329-7798 |
| Full Name | Elyria Internal Medicine, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 125 E Broad St, Elyria, Ohio |
| Authorized Official Name and Position | Niraj C Mistry (MANAGING PARTNER) |
| Authorized Official Contact | 4403297306 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elyria Internal Medicine, Inc 125 E Broad St Ste 202 Elyria OH 44035-6400 Ph: (440) 329-7306 | Elyria Internal Medicine, Inc 125 E Broad St Ste 202 Elyria OH 44035-6400 Ph: (440) 329-7306 |
| NPI Number | 1962737783 |
|---|---|
| Provider Enumeration Date | 10/13/2009 |
| Last Update Date | 03/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962737783 | NPI | - | NPPES |
| 3029565 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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