Provider Demographics
NPI:1013591783
Name:ELIFRITZ, AVERY MICHAEL (DO)
Entity Type:Individual
Prefix:
First Name:AVERY
Middle Name:MICHAEL
Last Name:ELIFRITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TOLEDO HOSPITAL, 2142 N. COVE BLVD
Mailing Address - Street 2:3RD FLOOR JOBST TOWER
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606
Mailing Address - Country:US
Mailing Address - Phone:419-291-8154
Mailing Address - Fax:
Practice Address - Street 1:TOLEDO HOSPITAL, 2142 N. COVE BLVD,
Practice Address - Street 2:3RD FLOOR JOBST TOWER
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-291-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.016127207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program