| Infectious Diseases Inc | |
|
329 N West St Lima OH 45801-4332 | |
| (419) 229-6007 | |
| (419) 229-0607 |
| Full Name | Infectious Diseases Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 329 N West St, Lima, Ohio |
| Authorized Official Name and Position | Wilfred Jg Ellis (CEO) |
| Authorized Official Contact | 4192296007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Diseases Inc 329 N West St Lima OH 45801-4332 Ph: (419) 229-6007 | Infectious Diseases Inc 329 N West St Lima OH 45801-4332 Ph: (419) 229-6007 |
| NPI Number | 1730109562 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 07/29/2010 |
| Medicare PECOS PAC ID | 5597945683 |
|---|---|
| Medicare Enrollment ID | O20110207000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730109562 | NPI | - | NPPES |
| 0804535 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 35060082 (Ohio) | Primary |
| Provider Name | Wilfred J G Ellis |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811936198 PECOS PAC ID: 3173544616 Enrollment ID: I20110207000620 |
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