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NPI Code Detail

MEDICARE: DR. PABLO D HERNANDEZ M.D.

MEDICARE: DR. PABLO D HERNANDEZ 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
12084P0015XPsychosomatic Medicine Physician74801OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992921902
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PABLO D HERNANDEZ M.D.
Provider Business Mailing Address
First Line : 1610 HAWTHORNE PARK
Second Line :
City : COLUMBUS
State : OH
Zip : 43203-1764
Country : US
Telephone Number : 614-258-1095
Fax Number :
Provider Business Practice Location Address
First Line : 199 S CENTRAL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1301
Country : US
Telephone Number : 614-278-0051
Fax Number : 614-279-0811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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