Provider Demographics
NPI:1114921442
Name:READ, ELIZABETH M (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:READ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 N SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9291
Mailing Address - Country:US
Mailing Address - Phone:419-887-8727
Mailing Address - Fax:419-491-0042
Practice Address - Street 1:6135 TRUST DR
Practice Address - Street 2:SUITE 114
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9358
Practice Address - Country:US
Practice Address - Phone:419-887-8727
Practice Address - Fax:419-491-0042
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063428207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2088879Medicaid
OH0865983Medicare ID - Type Unspecified
OH2088879Medicaid