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General NPI Number Information
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NPI Number | 1043215627
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Entity Type | Organization
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Legal Business Name | MIDOHIO CARDIOLOGY AND VASCULAR CONSULTANTS, INC
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 3705 OLENTANGY RIVER RD STE 100
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City | COLUMBUS
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State | OH
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Zip | 43214-3467
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Country | US
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Telephone | 614-262-6772
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Fax | 614-262-7074
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Provider Business Mailing Address
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Address Line | PO BOX 73444
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City | CLEVELAND
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State | OH
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Zip | 44193-0002
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Country | US
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Telephone | 614-265-2921
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Fax | 614-262-7074
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MRS. PEGGY L HYLTON
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Credential |
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Telephone | 614-573-5416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 35-055344
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 35-058287
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP-07581
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35-062660
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License Number State | OH
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