Healthcare Provider Details

I. General information

NPI: 1841223922
Provider Name (Legal Business Name): PETER J EMBI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 11/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 MEDICAL CENTER DRIVE
COLUMBUS OH
43210
US

IV. Provider business mailing address

700 ACKERMAN ROAD SUITE 385
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8093
  • Fax: 614-293-5631
Mailing address:
  • Phone: 614-947-3700
  • Fax: 614-947-3771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number35-081340
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: