Healthcare Provider Details

I. General information

NPI: 1588653646
Provider Name (Legal Business Name): DAVID HAUSWIRTH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6670 PERIMETER DR STE 270
DUBLIN OH
43016-8065
US

IV. Provider business mailing address

1810 MACKENZIE DR FL 2
COLUMBUS OH
43220-2967
US

V. Phone/Fax

Practice location:
  • Phone: 614-766-4903
  • Fax: 614-766-4945
Mailing address:
  • Phone: 614-273-2250
  • Fax: 614-273-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35079319
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35079319
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: