MEDICARE: ELOISA H JAHDI MD

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	35056010	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548228687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELOISA H JAHDI MD

Provider Business Mailing Address
First Line	:	19250 BAGLEY RD
Second Line	:	STE 101
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3347
Country	:	US
Telephone Number	:	440-627-2040
Fax Number	:	440-826-1910

Provider Business Practice Location Address
First Line	:	19250 BAGLEY RD
Second Line	:	STE 101
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3347
Country	:	US
Telephone Number	:	440-627-2040
Fax Number	:	440-826-1910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	11/10/2016

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Directions to “ ELOISA H JAHDI MD” Practice Location

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