Healthcare Provider Details

I. General information

NPI: 1699988998
Provider Name (Legal Business Name): COLUMBUS METROPOLITAN OB. GYN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 CHERRY WAY DR STE 100
GAHANNA OH
43230-8700
US

IV. Provider business mailing address

1375 CHERRY WAY DR STE 100
GAHANNA OH
43230-8700
US

V. Phone/Fax

Practice location:
  • Phone: 614-759-6200
  • Fax: 614-759-6443
Mailing address:
  • Phone: 614-759-6200
  • Fax: 614-759-6443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: TONI L CARROLL
Title or Position: OFFICE MANAGER
Credential:
Phone: 614-759-6200