Provider Demographics
NPI:1447203054
Name:LITAM, PATRICK P (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:P
Last Name:LITAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:239-432-8331
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:41201 SCHADDEN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2220
Practice Address - Country:US
Practice Address - Phone:440-324-0401
Practice Address - Fax:440-324-0405
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH61210207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341832420032OtherCARESOURCE
OH55077OtherQUAL CHOICE
OH3600179OtherUNITED HEALTHCARE
OHE61210OtherSUMMACARE
OH000000139926OtherANTHEM
OH830003427OtherRAILROAD MEDICARE
OH2003692Medicaid
OH10883OtherOHIO HEALTH CHOICE
F86942Medicare UPIN