Healthcare Provider Details
I. General information
NPI: 1013915420
Provider Name (Legal Business Name): SASIGARN ARUNCHAIYA BOWDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/09/2005
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
380 BUTTERFLY GARDENS DR
COLUMBUS OH
43215-7508
US
IV. Provider business mailing address
700 CHILDREN'S DRIVE
COLUMBUS OH
43205-2664
US
V. Phone/Fax
- Phone: 614-722-6200
- Fax:
- Phone: 614-722-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0205X |
| Taxonomy | Pediatric Endocrinology Physician |
| License Number | 35074739 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: