Healthcare Provider Details

I. General information

NPI: 1982689857
Provider Name (Legal Business Name): EILEEN MARIE SIROIS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS EILEEN MARIE DYRDEK

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 HOSPITAL DR
DUBLIN OH
43016-8518
US

IV. Provider business mailing address

5450 FRANTZ RD SUITE 250
DUBLIN OH
43016-4134
US

V. Phone/Fax

Practice location:
  • Phone: 614-544-8000
  • Fax: 614-544-8087
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number00013NM
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: