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NPI Code Detail

MEDICARE: PATRICK T. EITTER M.D.

MEDICARE:   PATRICK T. EITTER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician35-075344OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000389996OTHEROHBLUECROSS BLUESHIELD

General Provider Information

NPI Number : 1144285693
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK T. EITTER M.D.
Provider Business Mailing Address
First Line : PO BOX 65274
Second Line :
City : CHARLOTTE
State : NC
Zip : 28265-0274
Country : US
Telephone Number : 800-377-8721
Fax Number : 304-523-2241
Provider Business Practice Location Address
First Line : 921 E FRANKLIN ST
Second Line :
City : KENTON
State : OH
Zip : 43326-2020
Country : US
Telephone Number : 419-673-0761
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 07/08/2007

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Directions to “ PATRICK T. EITTER M.D.” Practice Location

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