Healthcare Provider Details

I. General information

NPI: 1578669321
Provider Name (Legal Business Name): STEPHEN GEORGE NOFFSINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1756 SAGAMORE RD
NORTHFIELD OH
44067-1086
US

IV. Provider business mailing address

30 E BROAD ST 11 TH FL
COLUMBUS OH
43215-3414
US

V. Phone/Fax

Practice location:
  • Phone: 330-467-7131
  • Fax:
Mailing address:
  • Phone: 614-466-9930
  • Fax: 614-644-9116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number35057591
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: