Provider Demographics
NPI:1518228121
Name:GHITA, OVIDIU (DO)
Entity Type:Individual
Prefix:
First Name:OVIDIU
Middle Name:
Last Name:GHITA
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 1:1436 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1323
Mailing Address - Country:US
Mailing Address - Phone:615-965-6108
Mailing Address - Fax:877-504-1444
Practice Address - Street 1:1436 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1323
Practice Address - Country:US
Practice Address - Phone:615-965-6108
Practice Address - Fax:877-504-1444
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAP2282058A16207R00000X
FLOS14402207R00000X
TN4915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine