Healthcare Provider Details

I. General information

NPI: 1649512708
Provider Name (Legal Business Name): PETER CHRISTIAN WILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

5475 RINGS RD STE 300
DUBLIN OH
43017-7537
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-3322
  • Fax: 614-556-1073
Mailing address:
  • Phone: 614-210-1885
  • Fax: 614-556-1073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35135606
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: