Healthcare Provider Details

I. General information

NPI: 1275544611
Provider Name (Legal Business Name): MARIA CHRISAN COURSER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 W 1ST AVE
COLUMBUS OH
43212-3601
US

IV. Provider business mailing address

1585 WALTHAM RD
COLUMBUS OH
43221-3863
US

V. Phone/Fax

Practice location:
  • Phone: 614-299-6333
  • Fax: 614-299-6054
Mailing address:
  • Phone: 614-481-3491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-08-3760
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-08-3760
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: