Individual
DR. ERIK JOSEPH MODLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 ELYRIA ST, LODI, OH 44254-1031
(330) 948-9939
(330) 948-2263
Mailing address
225 ELYRIA ST, LODI, OH 44254-1031
(330) 948-9939
(330) 948-2263
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.097905
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35.097905
OH
208M00000X
Hospitalist Physician
35.097905
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0053753
—
OH
01
—
1003849910
LODI COMMUNITY CARE CENTER TYPE 2 NPI #
OH
01
—
1801807870
LODI COMMUNITY HOSPITAL TYPE 2 NPI #
OH
01
—
2396081
LODI COMMUNITY HOSPITAL MEDICAID GROUP #
OH
01
—
3613031
LODI COMMUNITY HOSPITAL MEDICARE #
OH
Enumeration date
10/18/2006
Last updated
01/12/2016
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