Healthcare Provider Details

I. General information

NPI: 1578120176
Provider Name (Legal Business Name): GARRETT PATRICK DILTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 JASONWAY AVE STE A
COLUMBUS OH
43214-4359
US

IV. Provider business mailing address

810 JASONWAY AVE STE A
COLUMBUS OH
43214-4359
US

V. Phone/Fax

Practice location:
  • Phone: 614-442-3130
  • Fax: 614-442-3145
Mailing address:
  • Phone: 614-442-3130
  • Fax: 614-442-3150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35.155894
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: