Individual
DR. TEDROS ANDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2253 OLYMPIC ST, SPRINGFIELD, OH 45503-2736
(937) 717-4884
(937) 717-6207
Mailing address
2253 OLYMPIC ST, SPRINGFIELD, OH 45503-2736
(937) 717-4884
(937) 717-6207
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35091693
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2850571
—
OH
Enumeration date
09/29/2006
Last updated
03/17/2018
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