Tedros Andom, MD LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35-091693 Issued in OH

Legal business name

TEDROS ANDOM, MD LLC

Practice address

2624 Lexington Ave
Suite 340
Springfield, OH 45505-2607

Phone

(937) 688-1588

NPI assigned

Jun 24, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tedros Andom, MD

Title

Owner

Phone

(937) 323-2690

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1336300086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 LEXINGTON AVE",
            "address_2": "SUITE 340",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052607",
            "telephone_number": "937-688-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 LEXINGTON AVE",
            "address_2": "SUITE 340",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052607",
            "telephone_number": "937-688-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEDROS ANDOM, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "ANDOM",
        "authorized_official_first_name": "TEDROS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-323-2690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "35-091693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2854326",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanya L Taylor, RN
• Terry Lynn Taylor, RPH
• Susan Taynor
• Ted, LLC
• Rhonda Tedesco, COTA/L
• Yamini V Teegala, MD
• Emily Teeters, SLP
• Dorene Renee Tenorio, LPN
• Mark J Terrell, D.C.
• Ronald J Terrell Jr., PAC

• Surgery Physician in Springfield, OH
• Providers in Springfield, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.