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Individual
MEHRDAD EATESAM
Active
Individual
MEHRDAD EATESAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01082256A
IN
207R00000X
Internal Medicine Physician
Primary
036147385
IL
208M00000X
Hospitalist Physician
036147385
ID
390200000X
Student in an Organized Health Care Education/Training Program
125.069163
IL
Other
Enumeration date
08/23/2016
Last updated
01/27/2023
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