Healthcare Provider Details

I. General information

NPI: 1124283551
Provider Name (Legal Business Name): CHRISTIAN Y. VANEGAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 614-255-6913
  • Fax:
Mailing address:
  • Phone: 614-255-6900
  • Fax: 614-255-6901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.015217
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.097616
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: