Individual provider · Type 1 NPI
Theodore Marino Ezekiel Gagianas, PA-C
Surgical Physician Assistant · Salem, OH
NPI number
1396100749
Active
Practice location
1995 E State St
Salem, OH 44460-2423
Fax (330) 332-7847
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant | 363AS0400X | MA058003 (PA) |
| Surgical Physician Assistant | 363AS0400X | OA003697 (PA) |
| Surgical Physician Assistant Primary | 363AS0400X | 50.007297 (OH) |
Surgical Physician Assistant: Definition to come...
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About NPI 1396100749
Theodore Marino Ezekiel Gagianas, PA-C's National Provider Identifier is 1396100749, issued on Dec 29, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Salem, OH. The record was last updated on Dec 6, 2022.