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General NPI Number Information
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NPI Number | 1134324346
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL DISEASE CLINIC INC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1090 BEECHER CROSSING NORTH SUITE A
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City | GAHANNA
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State | OH
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Zip | 43230
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Country | US
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Telephone | 614-868-8667
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Fax | 614-416-0126
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Provider Business Mailing Address
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Address Line | 1090 BEECHER CROSSING NORTH SUITE A
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City | GAHANNA
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State | OH
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Zip | 43230
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Country | US
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Telephone | 614-868-8667
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Fax | 614-416-0126
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAN T STEINBAUGH
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Credential | MD
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Telephone | 614-868-8667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35031908
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License Number State | OH
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