Healthcare Provider Details
I. General information
NPI: 1831862358
Provider Name (Legal Business Name): PRIYAM T DOSHI MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/29/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
630 E RIVER ST
ELYRIA OH
44035-5902
US
IV. Provider business mailing address
1404 CHATEAU PL
AVON OH
44011-1275
US
V. Phone/Fax
- Phone: 440-329-7500
- Fax:
- Phone: 440-329-7500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 35.151962 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 35.151962 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: