Provider Demographics
NPI:1942207063
Name:UMLAUF, EDWARD SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:SCOTT
Last Name:UMLAUF
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 1:55 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2302
Mailing Address - Country:US
Mailing Address - Phone:740-317-6794
Mailing Address - Fax:
Practice Address - Street 1:55 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2302
Practice Address - Country:US
Practice Address - Phone:740-593-5551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004863208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH110214544OtherRR MEDICARE
WV1805199000Medicaid
OH0156441Medicaid
WV1805199000Medicaid
OH4056171Medicare PIN
E65549Medicare UPIN
OH4056173Medicare PIN