Provider Demographics
NPI:1922092857
Name:SOLOMON E ERULKAR MD INC
Entity Type:Organization
Organization Name:SOLOMON E ERULKAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KELBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-435-8568
Mailing Address - Street 1:801 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-1453
Mailing Address - Country:US
Mailing Address - Phone:419-435-8568
Mailing Address - Fax:419-435-8508
Practice Address - Street 1:801 PARK AVE
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-1453
Practice Address - Country:US
Practice Address - Phone:419-435-8568
Practice Address - Fax:419-435-8508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 2084P0800X
OH3003261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1922092857OtherNPI
OHSO9288811Medicare PIN