Healthcare Provider Details

I. General information

NPI: 1528016086
Provider Name (Legal Business Name): YASER RAMADAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 DODD DR
COLUMBUS OH
43210-1257
US

IV. Provider business mailing address

5190 BLAZER PKWY
DUBLIN OH
43017-1339
US

V. Phone/Fax

Practice location:
  • Phone: 614-292-9780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35 07 8946
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: