Healthcare Provider Details

I. General information

NPI: 1487685186
Provider Name (Legal Business Name): SAMUEL D WESTENSKOW DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 WEST CAMPUS OVAL CENTRAL OHIO SURGICAL INSTITUTE
NEW ALBANY OH
43054
US

IV. Provider business mailing address

1087 DENNISON AVE STE 7
COLUMBUS OH
43201-3201
US

V. Phone/Fax

Practice location:
  • Phone: 614-413-2233
  • Fax: 614-413-2234
Mailing address:
  • Phone: 614-459-2906
  • Fax: 614-459-2932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34008546
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: