Healthcare Provider Details

I. General information

NPI: 1154377281
Provider Name (Legal Business Name): MARIA WAIZMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 HORIZONS DR STE 100
COLUMBUS OH
43220-5280
US

IV. Provider business mailing address

4100 HORIZONS DR STE 100
COLUMBUS OH
43220-5280
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-1793
  • Fax: 614-457-0704
Mailing address:
  • Phone: 614-457-1793
  • Fax: 614-457-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35076988-W
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: