| NPI | 1912448747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD OPPONG CEO 614-440-2775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-08-22 |