Individual
DR. GRACE DASARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
801 MEDICAL DR, SUITE A, LIMA, OH 45804-4099
(419) 222-6622
(419) 224-0015
Mailing address
801 MEDICAL DR, SUITE A, LIMA, OH 45804-4099
(419) 222-6622
(419) 224-0015
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35084273-D
OH
208VP0000X
Pain Medicine Physician
35084273-D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000337172
ANTHEM
OH
05
—
2487812
—
OH
Enumeration date
01/19/2006
Last updated
04/01/2010
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