Elam, Mary Jane

Elam, Mary Jane is an individual health care provider with primary practice located at 1857 Millikin Rd , Columbus OH 43210-1215. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Elam, Mary Jane can be contacted via phone (614) 292-0110.

Contact Information

Primary practice address
1857 Millikin Rd Columbus OH 43210-1215
Fax: (614) 247-6074
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X 35054026 Ohio

Profile Details

NPI number 1255305736
LBN Legal business name Elam, Mary Jane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255305736 NPPES
Ohio MEDICAID 0749613

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