Healthcare Provider Details

I. General information

NPI: 1154199255
Provider Name (Legal Business Name): MICHAEL MOLNAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 W MAIN ST FL 3
SHELBY OH
44875-1490
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 567-241-7000
  • Fax: 567-241-7245
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0033995
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: