Healthcare Provider Details

I. General information

NPI: 1194212126
Provider Name (Legal Business Name): MICHAEL D GUTHRIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 KENNY RD STE 3300
COLUMBUS OH
43221-3502
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-9211
  • Fax: 614-366-2210
Mailing address:
  • Phone: 614-366-9211
  • Fax: 614-366-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35.148003
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number35.148003
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: