Healthcare Provider Details
I. General information
NPI: 1154698256
Provider Name (Legal Business Name): OHIO GASTROENTEROLOGY AND RHEUMATOLOGY SOLUTIONS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2011
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
387 COUNTY LINE RD W STE 225
WESTERVILLE OH
43082-6080
US
IV. Provider business mailing address
387 COUNTY LINE RD W STE 225
WESTERVILLE OH
43082-6080
US
V. Phone/Fax
- Phone: 614-776-5541
- Fax: 614-776-5561
- Phone: 614-776-5541
- Fax: 614-776-5561
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAYTH
SAYMEH
Title or Position: OWNER
Credential: D.O.
Phone: 315-877-4106