Healthcare Provider Details

I. General information

NPI: 1770522997
Provider Name (Legal Business Name): STEPHEN P. POVOSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 OLENTANGY RIVER RD
COLUMBUS OH
43212-3117
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4040
  • Fax: 614-293-3465
Mailing address:
  • Phone: 614-293-4040
  • Fax: 614-293-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number35061038
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: