Healthcare Provider Details

I. General information

NPI: 1023925435
Provider Name (Legal Business Name): MERIDIAN CLINICAL PARTNERS OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HIDDEN RAVINES DR STE A
POWELL OH
43065-9884
US

IV. Provider business mailing address

1985 HENDERSON RD # 2073
COLUMBUS OH
43220-2401
US

V. Phone/Fax

Practice location:
  • Phone: 570-445-2200
  • Fax: 223-213-2057
Mailing address:
  • Phone: 570-445-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIAM B SALISU
Title or Position: CHIEF OPERATING OFFICER
Credential: MD
Phone: 570-445-2200