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NPI Code Detail

MEDICARE: D'ETTA ELAINE HAMAN PA

MEDICARE: D'ETTA ELAINE HAMAN PA
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
1363AM0700XMedical Physician Assistant50001543OH

General Provider Information

NPI Number : 1457359911
Entity Type Code : Individual
Provider Name (Legal Business Name) : D'ETTA ELAINE HAMAN PA
Provider Business Mailing Address
First Line : 2950 MILLS RD
Second Line :
City : LIMA
State : OH
Zip : 45806-9305
Country : US
Telephone Number : 419-343-1510
Fax Number :
Provider Business Practice Location Address
First Line : 2950 MILLS RD
Second Line :
City : LIMA
State : OH
Zip : 45806-9305
Country : US
Telephone Number : 419-343-1510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 01/10/2022

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Directions to “ D'ETTA ELAINE HAMAN PA” Practice Location

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