Healthcare Provider Details

I. General information

NPI: 1609024579
Provider Name (Legal Business Name): BABAFUNMILAYO ABISOLA KASALI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5193 W BROAD ST STE 200
COLUMBUS OH
43228-1695
US

IV. Provider business mailing address

5400 FRANTZ RD STE 250
DUBLIN OH
43016-6102
US

V. Phone/Fax

Practice location:
  • Phone: 614-788-3700
  • Fax: 614-878-7005
Mailing address:
  • Phone: 614-544-6155
  • Fax: 614-544-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number123094
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: