Healthcare Provider Details

I. General information

NPI: 1306859186
Provider Name (Legal Business Name): INTERNAL MEDICINE CONSULTANTS OF COLUMBUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 02/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N MURRAY HILL RD
COLUMBUS OH
43228-1524
US

IV. Provider business mailing address

104 N MURRAY HILL RD
COLUMBUS OH
43228-1524
US

V. Phone/Fax

Practice location:
  • Phone: 614-878-6413
  • Fax: 614-878-1159
Mailing address:
  • Phone: 614-878-6413
  • Fax: 614-878-1159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT A PALMA
Title or Position: PRESIDENT
Credential: DO
Phone: 614-878-6413