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General NPI Number Information
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NPI Number | 1508868951
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Entity Type | Individual
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Provider Name | ELIAV GOV-ARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 812 N KEENE ST
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City | COLUMBIA
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State | MO
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Zip | 65201-6633
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Country | US
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Telephone | 573-817-3000
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Fax | 573-876-6950
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Provider Business Mailing Address
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Address Line | PO BOX 7687
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City | COLUMBIA
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State | MO
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Zip | 65205-7687
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Country | US
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Telephone | 573-882-2259
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | E3902
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2007033579
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | E3902
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | 2007033579
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License Number State | MO
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