Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. THEODORE MARINO EZEKIEL GAGIANAS, PA-C
ActiveMR. THEODORE MARINO EZEKIEL GAGIANAS, PA-C is a Surgical Physician Assistant healthcare provider located in SALEM, Ohio. NPI 1396100749 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · SALEM, OH
Registration Details
- NPI Number
- 1396100749
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 29, 2015 (10.669245918743 yrs)
- Last Updated
- Dec 6, 2022
- Licenses
-
MA058003 (PA)OA003697 (PA)50.007297 (OH)
Practice Information
- Address
-
1995 E STATE STSALEM, OH, 444602423Browse OH providers · Browse ZIP 44460
- Phone
- 3303327840
- Fax
- 3303327847
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.