Healthcare Provider Details

I. General information

NPI: 1053694026
Provider Name (Legal Business Name): SANDRA K MCHARG-BEVINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 HUNTLEY RD
COLUMBUS OH
43229-1012
US

IV. Provider business mailing address

6510 HUNTLEY RD
COLUMBUS OH
43229-1012
US

V. Phone/Fax

Practice location:
  • Phone: 614-846-5750
  • Fax: 614-846-6063
Mailing address:
  • Phone: 614-846-5750
  • Fax: 614-846-6063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberS4198
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: