MEDICARE: MOUNT CARMEL HEALTH PROVIDERS INC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1720255730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT CARMEL HEALTH PROVIDERS INC

Provider Business Mailing Address
First Line	:	4310 CLIME RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3496
Country	:	US
Telephone Number	:	614-274-7799
Fax Number	:	614-274-3209

Provider Business Practice Location Address
First Line	:	4310 CLIME RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3496
Country	:	US
Telephone Number	:	614-274-7799
Fax Number	:	614-274-3209

Authorized Official
Title or Position	:	COO
Name	:	PAUL C SCHUTTE
Credential	:
Telephone Number	:	614-546-4424

Provider Enumeration Date	:	05/09/2008
Last Update Date	:	05/09/2008

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