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NPI Code Detail

MEDICARE: OCCUPATIONAL & PREVENTIVE MEDICINE INC.

MEDICARE: OCCUPATIONAL & PREVENTIVE MEDICINE 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
12083P0500XPreventive Medicine/Occupational Environmental Medicine Physician35-03-1751OH

General Provider Information

NPI Number : 1861524795
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCCUPATIONAL & PREVENTIVE MEDICINE INC.
Provider Business Mailing Address
First Line : 4660 ROBERTS RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-9671
Country : US
Telephone Number : 614-876-8386
Fax Number :
Provider Business Practice Location Address
First Line : 4660 ROBERTS RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-9671
Country : US
Telephone Number : 614-876-8386
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN WILLIAM CUNNINGHAM
Credential : M.D.
Telephone Number : 614-876-8386
Provider Enumeration Date : 03/09/2007
Last Update Date : 08/22/2020

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