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General NPI Number Information
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NPI Number | 1134145261
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Entity Type | Individual
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Provider Name | TEJAS B LODHAWALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 885 N SANDUSKY AVE
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City | UPPER SANDUSKY
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State | OH
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Zip | 43351-1098
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Country | US
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Telephone | 419-294-4991
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Fax | 419-209-0278
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Provider Business Mailing Address
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Address Line | 885 N SANDUSKY AVE
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City | UPPER SANDUSKY
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State | OH
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Zip | 43351-1098
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Country | US
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Telephone | 419-294-4991
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Fax | 419-209-0278
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 036-116402
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35-093106
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35184146
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License Number State | OH
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