Individual
GENEVRA ADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 HAYES AVE, SANDUSKY, OH 44870-3323
(419) 557-7076
Mailing address
1111 HAYES AVE, SANDUSKY, OH 44870-3323
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.139537
OH
208M00000X
Hospitalist Physician
35.139537
OH
Other
Enumeration date
03/31/2017
Last updated
06/30/2020
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