Healthcare Provider Details

I. General information

NPI: 1831118363
Provider Name (Legal Business Name): AVROM DAVID EPSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 NEIL AVE SUITE 440
COLUMBUS OH
43215
US

IV. Provider business mailing address

262 NEIL AVE SUITE 440
COLUMBUS OH
43215-7309
US

V. Phone/Fax

Practice location:
  • Phone: 614-221-4166
  • Fax: 614-221-5524
Mailing address:
  • Phone: 614-221-4166
  • Fax: 614-221-5524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number35067301
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35-06-7301-E
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: