Healthcare Provider Details

I. General information

NPI: 1659373389
Provider Name (Legal Business Name): RICHARD B ZELLMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

P O BOX 636042 DEPT 6042
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-4943
  • Fax: 614-263-1056
Mailing address:
  • Phone: 614-457-8180
  • Fax: 614-442-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number35072991
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35072991
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: