Healthcare Provider Details

I. General information

NPI: 1801887989
Provider Name (Legal Business Name): GINA M BACHMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2005
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10330 SAWMILL PKWY STE 600
POWELL OH
43065-7796
US

IV. Provider business mailing address

10330 SAWMILL PKWY STE 600
POWELL OH
43065-7796
US

V. Phone/Fax

Practice location:
  • Phone: 614-760-5959
  • Fax: 614-760-5985
Mailing address:
  • Phone: 614-627-1850
  • Fax: 614-760-5985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-090214
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: