MEDICARE: DERICK TADOH ASAH DO

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	34.012497	OH
2	207RP1001X	Pulmonary Disease Physician	5151012379	MI
3	207R00000X	Internal Medicine Physician	012497	OH
4	207RP1001X	Pulmonary Disease Physician	34.012497	OH
5	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	5101023744	MI

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	:	1790178192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DERICK TADOH ASAH DO

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-0727
Country	:	US
Telephone Number	:
Fax Number	:	614-544-6370

Provider Business Practice Location Address
First Line	:	335 GLESSNER AVE STE 1430
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44903-2269
Country	:	US
Telephone Number	:	419-522-0320
Fax Number	:	419-522-0350

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

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	01/14/2026

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