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General NPI Number Information
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NPI Number | 1053402487
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Entity Type | Individual
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Provider Name | VINCENT J OBIAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-7874
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE DEPT OF
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-2704
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Fax | 410-500-4266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 35-088664
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | MD037351
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35-088664
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D94365
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License Number State | MD
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