Healthcare Provider Details

I. General information

NPI: 1427552736
Provider Name (Legal Business Name): EVAN PETER ROTAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 MCNAUGHTEN RD STE 200
COLUMBUS OH
43213-5111
US

IV. Provider business mailing address

85 MCNAUGHTEN RD STE 200
COLUMBUS OH
43213-5111
US

V. Phone/Fax

Practice location:
  • Phone: 614-627-2000
  • Fax:
Mailing address:
  • Phone: 614-627-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number35.156013
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: