Healthcare Provider Details

I. General information

NPI: 1235661034
Provider Name (Legal Business Name): LAURA WINGERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 CHILDRENS DR
COLUMBUS OH
43205-2649
US

IV. Provider business mailing address

630 CHILDRENS DR
COLUMBUS OH
43205-2649
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-2000
  • Fax:
Mailing address:
  • Phone: 614-722-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.138835
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: