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NPI Code Detail

MEDICARE: ACHILLES E LITAO M.D.

MEDICARE: ACHILLES E LITAO 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
1208000000XPediatrics Physician35086572OH

General Provider Information

NPI Number : 1164481305
Entity Type Code : Individual
Provider Name (Legal Business Name) : ACHILLES E LITAO M.D.
Provider Business Mailing Address
First Line : 1029 S TRIMBLE RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-3427
Country : US
Telephone Number : 419-522-3341
Fax Number : 419-522-1110
Provider Business Practice Location Address
First Line : 1029 S TRIMBLE RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-3427
Country : US
Telephone Number : 419-522-3341
Fax Number : 419-522-1110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 02/24/2021

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Directions to “ ACHILLES E LITAO M.D.” Practice Location

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