Healthcare Provider Details

I. General information

NPI: 1710085519
Provider Name (Legal Business Name): REINHARD A GAHBAUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 HARD RD
COLUMBUS OH
43235-1740
US

IV. Provider business mailing address

812 HARD RD
COLUMBUS OH
43235-1740
US

V. Phone/Fax

Practice location:
  • Phone: 614-436-4586
  • Fax:
Mailing address:
  • Phone: 614-436-4586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35049473
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: