Healthcare Provider Details

I. General information

NPI: 1376463943
Provider Name (Legal Business Name): ABIGAIL MARIE KLOSS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6805 BOBCAT WAY STE 112
DUBLIN OH
43016-1681
US

IV. Provider business mailing address

10378 MACKENZIE WAY
DUBLIN OH
43017-8774
US

V. Phone/Fax

Practice location:
  • Phone: 614-793-5619
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010313RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: