Healthcare Provider Details

I. General information

NPI: 1023003415
Provider Name (Legal Business Name): EMIL MITCHEL OPREMCAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 02/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 NEIL AVE SUITE 220
COLUMBUS OH
43215-7310
US

IV. Provider business mailing address

262 NEIL AVE SUITE 220
COLUMBUS OH
43215-7310
US

V. Phone/Fax

Practice location:
  • Phone: 614-464-3937
  • Fax: 614-464-0088
Mailing address:
  • Phone: 614-464-3937
  • Fax: 614-464-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35-0475920
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: