Healthcare Provider Details

I. General information

NPI: 1457746372
Provider Name (Legal Business Name): VICTORIA POWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 NIKE DR
HILLIARD OH
43026-9813
US

IV. Provider business mailing address

5450 FRANTZ RD STE 360
DUBLIN OH
43016-4134
US

V. Phone/Fax

Practice location:
  • Phone: 614-533-6810
  • Fax: 614-777-9032
Mailing address:
  • Phone: 614-544-6155
  • Fax: 614-544-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34.013893
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: