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General NPI Number Information
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NPI Number | 1215964283
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Entity Type | Organization
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Legal Business Name | RIVERSIDE OBSTETRICIANS AND GYNECOLOGISTS, INC.
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 3545 OLENTANGY RIVER RD STE 114
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City | COLUMBUS
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State | OH
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Zip | 43214-3907
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Country | US
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Telephone | 614-268-3581
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Fax | 614-268-8171
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Provider Business Mailing Address
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Address Line | 3545 OLENTANGY RIVER RD STE 114
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City | COLUMBUS
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State | OH
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Zip | 43214-3907
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Country | US
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Telephone | 614-268-3581
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Fax | 614-268-8171
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. DREMA WARD
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Credential |
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Telephone | 614-268-3581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35031754
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License Number State | OH
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