Healthcare Provider Details

I. General information

NPI: 1740491364
Provider Name (Legal Business Name): MARGUERITE WESTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGUERITE WINSLOW

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 POLARIS PKWY SUITE 2150
WESTERVILLE OH
43082-7989
US

IV. Provider business mailing address

5400 FRANTZ RD SUITE 250
DUBLIN OH
43016-4144
US

V. Phone/Fax

Practice location:
  • Phone: 614-533-3280
  • Fax: 614-533-3289
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number65013-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number57010839
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number27596
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35090718
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: