Healthcare Provider Details

I. General information

NPI: 1255052916
Provider Name (Legal Business Name): MEGHAN ELIZABETH TOMCZAK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 07/27/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 OLENTANGY RIVER RD STE 4330
COLUMBUS OH
43214-3937
US

IV. Provider business mailing address

41800 W 11 MILE RD STE 109
NOVI MI
48375-1818
US

V. Phone/Fax

Practice location:
  • Phone: 614-255-6900
  • Fax: 614-255-6901
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0032345
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberRN399304
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: