Healthcare Provider Details

I. General information

NPI: 1356439228
Provider Name (Legal Business Name): BRIAN L BACHELDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5156 E MAIN ST
COLUMBUS OH
43213-2424
US

IV. Provider business mailing address

1395 NW 167TH ST
MIAMI GARDENS FL
33169-5710
US

V. Phone/Fax

Practice location:
  • Phone: 614-702-7655
  • Fax: 614-706-1770
Mailing address:
  • Phone: 614-702-7655
  • Fax: 614-706-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35--049315
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.049315
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-049315
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: