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NPI Code Detail

MEDICARE: MR. TARIQ OMAR LESCOUFLAIR M.D.

MEDICARE: MR. TARIQ OMAR LESCOUFLAIR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician35.138526OH

General Provider Information

NPI Number : 1154616175
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TARIQ OMAR LESCOUFLAIR M.D.
Provider Business Mailing Address
First Line : PO BOX 7527
Second Line :
City : DUBLIN
State : OH
Zip : 43017-0727
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 285 E STATE ST STE 400
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-4368
Country : US
Telephone Number : 614-566-7370
Fax Number : 614-533-0187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2011
Last Update Date : 11/14/2023

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