Healthcare Provider Details

I. General information

NPI: 1396231098
Provider Name (Legal Business Name): NORTHWEST PEDIATRICS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7275 SAWMILL RD
DUBLIN OH
43016
US

IV. Provider business mailing address

7275 SAWMILL RD
DUBLIN OH
43016-9021
US

V. Phone/Fax

Practice location:
  • Phone: 614-766-6321
  • Fax: 614-339-0153
Mailing address:
  • Phone: 614-766-6321
  • Fax: 614-339-0153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT A RHYAN
Title or Position: OWNER / PRESIDENT
Credential: MBA
Phone: 614-339-0153