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NPI Code Detail

MEDICARE: ELIZABETH PERSTIN MD

MEDICARE:   ELIZABETH  PERSTIN  MD
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
1174400000XSpecialist35-83542OH
2207P00000XEmergency Medicine Physician35083542OH
3207R00000XInternal Medicine Physician35083542OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P01058232OTHEROHRAILROAD MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1558329391
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH PERSTIN MD
Provider Business Mailing Address
First Line : 5636 WORCESTER DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-3059
Country : US
Telephone Number : 216-253-9040
Fax Number :
Provider Business Practice Location Address
First Line : 5636 WORCESTER DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-3059
Country : US
Telephone Number : 216-253-9040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 08/21/2012

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Directions to “ ELIZABETH PERSTIN MD” Practice Location

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