Healthcare Provider Details

I. General information

NPI: 1316441959
Provider Name (Legal Business Name): MARGARET ANN ROSELLEN KIRWIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAGGIE KIRWIN

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8305
  • Fax: 614-293-3124
Mailing address:
  • Phone: 614-293-8305
  • Fax: 614-293-3124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.138662
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.138662
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35.138662
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: