Individual
DR. ELIYAZAR GADDAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
951 COMMERCE PKWY, SUITE 100, LIMA, OH 45804-4040
(419) 224-5915
(419) 224-5918
Mailing address
951 COMMERCE PKWY, SUITE 101, LIMA, OH 45804-4040
(419) 998-4575
(419) 998-4586
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036083544
IL
207RC0000X
Cardiovascular Disease Physician
Primary
35.127156
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083544
—
IL
05
—
1073561858
—
WI
Enumeration date
05/04/2006
Last updated
08/28/2020
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