MEDICARE: BOB PAUL ERDELYI 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	207R00000X	Internal Medicine Physician	35075919	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000699799	OTHER	OH	ANTHEM
2	110194369	OTHER	OH	RRMCR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000120129	OTHER	OH	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780689109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOB PAUL ERDELYI MD

Provider Business Mailing Address
First Line	:	PO BOX 449
Second Line	:
City	:	MARIETTA
State	:	OH
Zip	:	45750-0449
Country	:	US
Telephone Number	:	740-374-4500
Fax Number	:	740-374-5887

Provider Business Practice Location Address
First Line	:	400 MATTHEW ST
Second Line	:	STE 211
City	:	MARIETTA
State	:	OH
Zip	:	45750-1656
Country	:	US
Telephone Number	:	740-373-6725
Fax Number	:	740-374-4922

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	08/17/2011

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Directions to “ BOB PAUL ERDELYI MD” Practice Location

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