| NPI | 1053605519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALEN HUBERT DAVIS Doctor Of Internal Medicine 614-501-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OH 3522760) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-09 |