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NPI Code Detail

MEDICARE: ESSAM BASHIR ELASHI MD

MEDICARE:   ESSAM BASHIR ELASHI  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
1207RN0300XNephrology Physician35072580OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110207740OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000129589OTHEROHANTHEM BC/BS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629077029
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESSAM BASHIR ELASHI MD
Provider Business Mailing Address
First Line : 1031 PIERCE STREET
Second Line : SUITE D
City : SANDUSKY
State : OH
Zip : 44870
Country : US
Telephone Number : 419-557-5541
Fax Number : 419-557-5542
Provider Business Practice Location Address
First Line : 1221 HAYES AVE
Second Line : SUITE F
City : SANDUSKY
State : OH
Zip : 44870-3345
Country : US
Telephone Number : 419-627-8403
Fax Number : 419-627-1962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 10/30/2015

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