Individual
DR. EDWARD A CARRILLO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5026 NORTH RIDGE WEST, ASHTABULA, OH 44004-9508
(440) 969-1151
(440) 969-1152
Mailing address
5026 NORTH RIDGE WEST, ASHTABULA, OH 44004-9508
(440) 969-1151
(440) 969-1152
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35045452
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0453325
—
OH
01
—
34140083300
BWC
OH
01
—
35045452
STATE LICENSE NUMBER
OH
Enumeration date
12/22/2005
Last updated
03/07/2023
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